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Tennessee 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
$1,100.00 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.03 / $781.61 / $1,276.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,984.00 / $5,486.00 / $9,283.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$778.25 / $1,062.66 / $1,711.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.07 / $1,097.89 / $1,603.29
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $7,277.68 / $7,446.32
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,581.31 / $6,777.31 / $6,781.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,905.00 / $6,073.00 / $10,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.76 / $920.02 / $1,617.85