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Louisiana rates for HCPCS 21440

Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.02 / $1,850.00 / $3,884.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.85 / $734.10 / $1,018.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,582.88 / $4,910.38 / $6,937.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.40 / $838.71 / $1,064.05
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $578.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $1,200.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.89 / $791.41 / $1,222.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.00 / $2,415.00 / $7,085.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.66 / $647.09 / $1,089.81