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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
$1,096.48 / $2,570.40 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $870.96 / $1,778.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $870.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $6,606.93 / $9,772.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,202.26 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,071.52 / $1,659.59
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $7,244.36 / $7,244.36
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,760.83 / $6,760.83 / $6,760.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $933.25 / $1,548.82