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Complex Open Repair of an Upper Jaw Fracture

West 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?

$1,608

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

Insurers have agreed to pay about $1,608 for this procedure. That total is two separate charges: $832 to the doctor who performs it, and $776 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 4 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$832$776 to $871
Facility feeThe hospital or surgery center$776$776 to $1,413

How much rates vary

Facilitymedian $776 · 10th to 90th $776 to $2,344Professionalmedian $832 · 10th to 90th $724 to $1,122
$50$200$1K$5Kfacility $776professional $832

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
$776.25
Median
$776.25
Typical High
$2,344.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$831.76
Typical High
$870.96
CareSource
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$1,023.29
CareSource
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$1,258.93
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,174.90
Typical High
$6,760.83
United
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$7,943.28
Typical High
$16,595.87
United
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$891.25
Typical High
$1,258.93

Where West 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

West Virginia· 50th of 50

$1,608

$832 physician + $776 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.