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Complex Open Repair of an Upper Jaw Fracture

New York rates for HCPCS 21423

A surgery performed through an open incision to repair a fracture across the upper jaw, at the level where it separates the tooth-bearing bone from the rest of the face, in a case that is more complicated than usual, such as a fracture with many bone fragments or one that involves nerve pathways through the bone. The surgeon directly accesses and realigns the broken bone. It is used for a more complex version of this specific level of midface fracture rather than a straightforward break.

Rates data updated July 2026.

How much does Complex Open Repair of an Upper Jaw Fracture cost?

$6,800

Typical total for the visit. In New York, July 2026.

Insurers have agreed to pay about $6,800 for this procedure. That total is two separate charges: $912 to the doctor who performs it, and $5,888 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$912$813 to $1,318
Facility feeThe hospital or surgery center$5,888$3,090 to $9,333

How much rates vary

Facilitymedian $5,888 · 10th to 90th $1,148 to $12,023Professionalmedian $912 · 10th to 90th $708 to $2,344
$1K$2K$5K$10Kfacility $5,888professional $912

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$4,570.88
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$912.01
Typical High
$2,137.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$7,762.47
Typical High
$13,489.63
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$870.96
Typical High
$2,041.74
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$37,153.52
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,148.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$1,258.93
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,288.25
Typical High
$3,630.78
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,122.02
Typical High
$2,818.38
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,202.26
Typical High
$1,819.70
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,047.13
Typical High
$1,659.59
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$1,023.29
Typical High
$2,089.30
United
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$5,495.41
Typical High
$13,182.57
United
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,071.52
Typical High
$3,388.44
Univera
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$954.99
Typical High
$3,715.35
Univera
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,000.00
Typical High
$2,398.83

Where New York sits

The same service costs 9.9 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

New York· 15th of 50

$6,800

$912 physician + $5,888 facility

IN $15,967WV $1,608

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.