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Arkansas rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$666.42 / $1,074.00 / $3,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.17 / $680.91 / $879.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,411.79 / $1,411.79 / $1,694.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.78 / $822.94 / $987.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,734.43 / $1,734.43 / $1,734.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.98 / $941.32 / $1,164.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.00 / $1,427.00 / $2,814.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.28 / $778.10 / $1,345.73