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Complex Open Repair of an Upper Jaw Fracture

Virginia 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?

$4,191

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

Insurers have agreed to pay about $4,191 for this procedure. That total is two separate charges: $955 to the doctor who performs it, and $3,236 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$955$832 to $1,288
Facility feeThe hospital or surgery center$3,236$1,000 to $7,244

How much rates vary

Facilitymedian $3,236 · 10th to 90th $832 to $10,471Professionalmedian $955 · 10th to 90th $741 to $2,138
$1K$2K$5K$10K$20Kfacility $3,236professional $955

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
$870.96
Median
$5,495.41
Typical High
$10,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$870.96
Typical High
$3,467.37
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$7,413.10
Typical High
$9,332.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,122.02
Typical High
$1,949.84
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,047.13
Typical High
$5,495.41
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$954.99
Typical High
$1,659.59
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$891.25
Typical High
$1,047.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,318.26
Typical High
$1,862.09
Medcost
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,023.29
Typical High
$1,584.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Sentara
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,023.29
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,023.29
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$10,715.19
Typical High
$22,387.21
United
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$933.25
Typical High
$1,548.82

Where Virginia 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

Virginia· 34th of 50

$4,191

$955 physician + $3,236 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.