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New Mexico 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
$1,122.02 / $1,174.90 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $812.83 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,148.15 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,096.48 / $1,659.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,174.90 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $11,220.18 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,096.48 / $1,513.56