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Complex Open Repair of an Upper Jaw Fracture

Pennsylvania 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?

$6,202

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

Insurers have agreed to pay about $6,202 for this procedure. That total is two separate charges: $832 to the doctor who performs it, and $5,370 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$832$741 to $977
Facility feeThe hospital or surgery center$5,370$3,548 to $7,244

How much rates vary

Facilitymedian $5,370 · 10th to 90th $1,047 to $8,511Professionalmedian $832 · 10th to 90th $724 to $1,259
$1K$2K$5K$10Kfacility $5,370professional $832

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
$1,047.13
Median
$5,370.32
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$831.76
Typical High
$1,174.90
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,122.02
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$954.99
Typical High
$1,621.81
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,148.15
Typical High
$1,479.11
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$954.99
Typical High
$1,548.82
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$4,786.30
Typical High
$8,511.38
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$831.76
Typical High
$4,168.69
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$891.25
Typical High
$933.25
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$3,548.13
Typical High
$6,309.57
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$776.25
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,370.32
Typical High
$17,378.01
United
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$891.25
Typical High
$1,513.56

Where Pennsylvania 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

Pennsylvania· 19th of 50

$6,202

$832 physician + $5,370 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.