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West Virginia rates for HCPCS 21453

Closed treatment of mandibular fracture with interdental fixation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$965.12 / $1,126.47 / $40,094.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$838.50 / $1,006.20 / $1,096.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,490.09 / $1,490.09 / $1,490.09
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,650.42 / $25,650.42 / $25,650.42