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Missouri 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
Facility
Modifier
Low / Median / High Price
$943.71 / $4,908.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.42 / $806.27 / $1,262.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $12,405.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.44 / $940.55 / $1,470.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$781.20 / $1,072.92 / $1,752.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.57 / $1,128.78 / $4,462.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.66 / $1,079.29 / $6,581.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,156.00 / $4,000.00 / $10,781.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.58 / $1,021.88 / $1,635.49