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Indiana rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$554.53 / $927.00 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$527.45 / $630.77 / $799.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,943.00 / $5,126.00 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.28 / $396.80 / $565.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533.54 / $693.60 / $872.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.71 / $703.68 / $959.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$881.00 / $881.00 / $1,044.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.13 / $699.95 / $1,197.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $3,870.00 / $6,436.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.75 / $707.36 / $1,307.17