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Maine 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
Professional
Modifier
Low / Median / High Price
$571.09 / $771.34 / $889.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,491.08 / $26,019.37 / $30,263.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.78 / $948.31 / $1,321.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.91 / $1,067.66 / $1,541.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.15 / $998.66 / $1,532.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.09 / $875.95 / $889.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.02 / $1,011.03 / $1,385.70