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Utah rates for HCPCS 21423

Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches

Facilitymedian $6,026 · 10th–90th $3,162–$10,2330%10%10th90th$6,026Professionalmedian $1,122 · 10th–90th $724–$4,3650%10%10th90th$1,122$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,047.13 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,122.02 / $1,659.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,737.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $10,471.29 / $15,135.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,318.26 / $2,089.30
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,445.44 / $1,819.70
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,202.26 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $1,318.26