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New Hampshire rates for HCPCS 21423

Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches

Facilitymedian $3,388 · 10th–90th $2,399–$14,7910%10%20%10th90th$3,388Professionalmedian $1,175 · 10th–90th $813–$1,9950%10%20%10th90th$1,175$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,818.38 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $933.25 / $1,995.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,623.41 / $9,120.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,513.56 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,318.26 / $2,398.83
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,202.26 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,202.26 / $2,290.87
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $436.52 / $954.99