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Complex Open Repair of an Upper Jaw Fracture

Maine rates for HCPCS 21423

A surgery performed through an open incision to repair a fracture across the upper jaw, at the level where it separates the tooth-bearing bone from the rest of the face, in a case that is more complicated than usual, such as a fracture with many bone fragments or one that involves nerve pathways through the bone. The surgeon directly accesses and realigns the broken bone. It is used for a more complex version of this specific level of midface fracture rather than a straightforward break.

Rates data updated July 2026.

How much does Complex Open Repair of an Upper Jaw Fracture cost?

$955

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $955 for this service. Most negotiated rates run $832 to $1,175.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $12,023 · 10th to 90th $12,023 to $12,023Professionalmedian $955 · 10th to 90th $741 to $1,514
$1K$2K$5K$10Kfacility $12,023professional $955

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$831.76
Typical High
$977.24
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,148.15
Typical High
$1,737.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,174.90
Typical High
$1,778.28
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,071.52
Typical High
$2,041.74
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$851.14
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$12,022.64
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,023.29
Typical High
$1,659.59

Where Maine sits

The same service costs 7.8 times more in California than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 40th of 51

$955

CA $6,166KY $794

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.