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Kansas rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,700.00 / $4,387.00 / $10,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.78 / $710.47 / $1,128.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.83 / $711.56 / $848.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.00 / $442.00 / $442.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$609.54 / $859.49 / $1,448.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.78 / $940.40 / $2,505.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$629.71 / $875.58 / $5,257.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$860.06 / $2,081.00 / $3,842.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.33 / $788.38 / $1,115.45