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Missouri 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
$1,547.00 / $5,389.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.98 / $698.30 / $1,111.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $12,405.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.32 / $820.43 / $1,316.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$652.22 / $943.36 / $1,549.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.83 / $992.15 / $4,039.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.34 / $965.56 / $5,175.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,858.00 / $4,000.00 / $11,258.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.75 / $867.64 / $1,485.68