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Maryland rates for HCPCS 21423

Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.27 / $805.27 / $869.21
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$918.26 / $950.67 / $1,120.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $507.00 / $641.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.08 / $1,068.78 / $1,831.64
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.10 / $1,075.99 / $1,407.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.28 / $855.50 / $1,632.29
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.49 / $959.21 / $1,180.82