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Nebraska 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
$642.80 / $8,042.03 / $19,276.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.58 / $642.80 / $2,740.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,522.85 / $8,579.33 / $16,595.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.82 / $1,038.88 / $1,422.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.93 / $903.93 / $903.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.71 / $1,407.83 / $1,764.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.58 / $955.67 / $4,037.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.85 / $1,199.89 / $4,505.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$884.26 / $1,307.85 / $1,740.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.00 / $1,267.33 / $1,759.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $6,451.00 / $7,934.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.85 / $1,271.77 / $1,656.26