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North Carolina 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
$781.61 / $1,245.00 / $10,561.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.36 / $833.25 / $1,534.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.89 / $1,220.84 / $2,116.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.10 / $606.10 / $606.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.23 / $1,125.26 / $1,990.12
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.61 / $984.41 / $1,603.58
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.41 / $987.00 / $1,023.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $1,039.20 / $2,153.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,183.00 / $12,216.00 / $19,066.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$649.77 / $963.04 / $2,079.21
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $7,277.68 / $7,277.68
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,777.31 / $6,777.31 / $6,781.05