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Nebraska 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
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.27 / $729.58 / $3,873.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,086.90 / $11,951.75 / $23,118.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.15 / $1,193.45 / $1,591.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.00 / $1,734.88 / $2,311.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$729.58 / $1,276.77 / $7,221.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.90 / $1,556.11 / $2,220.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$927.85 / $1,767.06 / $2,474.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,276.00 / $1,651.65 / $2,311.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.90 / $1,556.11 / $2,026.56