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Arizona rates for HCPCS 21431

Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of denture or splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $758.58 / $2,238.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $5,370.32 / $7,943.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $977.24 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $831.76 / $1,445.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $954.99 / $7,079.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $851.14 / $5,128.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $6,456.54 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $724.44 / $1,258.93