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Washington rates for HCPCS 21423

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

Facilitymedian $2,042 · 10th–90th $1,023$19,4980%10%10th90th$2,042Professionalmedian $1,148 · 10th–90th $724$2,1880%10%20%10th90th$1,148$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
$1,513.56 / $8,128.31 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,023.29 / $1,995.26
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,481.54 / $14,791.08 / $28,840.32
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,318.26 / $2,344.23
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,621.81 / $11,481.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,584.89 / $8,709.64
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $1,584.89
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,096.48
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,584.89 / $2,089.30
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $14,791.08 / $28,840.32
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $16,595.87 / $33,113.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $2,089.30
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $831.76 / $1,513.56