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Maine 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
$741.31 / $933.25 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,174.90 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,174.90 / $1,778.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,071.52 / $2,041.74
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,096.48 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,023.29 / $1,584.89