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Missouri 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
$707.95 / $3,548.13 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $645.65 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $524.81 / $891.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $776.25 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $741.31 / $1,174.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $831.76 / $3,162.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $912.01 / $5,623.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,630.27 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $645.65 / $1,071.52