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Michigan 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
$683.58 / $1,108.68 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.68 / $667.58 / $928.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$771.06 / $909.53 / $1,279.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.03 / $939.61 / $1,610.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $619.78 / $1,255.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.69 / $4,112.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.62 / $683.58 / $975.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.55 / $485.19 / $831.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $5,806.00 / $8,339.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.94 / $675.17 / $924.54