go back

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
$814.38 / $2,095.00 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.27 / $814.38 / $1,039.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.81 / $1,162.17 / $1,491.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,233.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$756.44 / $988.52 / $1,672.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$805.65 / $1,208.47 / $1,969.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$899.00 / $11,259.00 / $16,897.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.88 / $1,156.65 / $1,785.23