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Alaska rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,872.00 / $7,340.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.34 / $2,756.65 / $3,273.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.03 / $1,797.70 / $3,093.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.26 / $2,756.65 / $4,582.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,432.95 / $2,064.98 / $4,149.60
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,156.00 / $3,109.75 / $4,038.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$649.01 / $2,782.31 / $4,582.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,217.25 / $3,002.55 / $4,173.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,962.56 / $2,962.56 / $2,962.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,696.40 / $2,559.19 / $3,732.08