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Idaho 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
$3,422.00 / $4,500.00 / $8,622.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.57 / $1,043.13 / $1,448.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.06 / $1,050.75 / $1,247.77
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$667.59 / $1,262.34 / $1,738.31
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.60 / $1,219.21 / $1,642.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $972.69 / $1,223.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,072.74 / $7,629.08 / $12,587.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,176.67 / $1,384.32 / $1,642.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.95 / $1,055.75 / $1,474.07