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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,818.38 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $912.01 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,623.41 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,513.56 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,348.96 / $2,454.71
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,258.93 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,174.90 / $2,137.96
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $954.99