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Rhode Island 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
$3,019.95 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $758.58 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $707.95 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $977.24 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $7,413.10 / $13,182.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $870.96 / $1,548.82