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Complex Open Repair of an Upper Jaw Fracture

Ohio 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?

$6,119

Typical total for the visit. In Ohio, July 2026.

Insurers have agreed to pay about $6,119 for this procedure. That total is two separate charges: $871 to the doctor who performs it, and $5,248 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$871$759 to $1,202
Facility feeThe hospital or surgery center$5,248$2,951 to $9,550

How much rates vary

Facilitymedian $5,248 · 10th to 90th $1,514 to $12,589Professionalmedian $871 · 10th to 90th $676 to $2,692
$50$200$1K$5Kfacility $5,248professional $871

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
$1,513.56
Median
$7,762.47
Typical High
$12,589.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$831.76
Typical High
$7,943.28
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$4,365.16
Typical High
$16,982.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$891.25
Typical High
$1,380.38
CareSource
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,047.13
Typical High
$1,584.89
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$21,379.62
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,047.13
Typical High
$1,584.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$851.14
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$5,011.87
Typical High
$11,220.18
United
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$891.25
Typical High
$1,445.44

Where Ohio 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

Ohio· 20th of 50

$6,119

$871 physician + $5,248 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.