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Maryland rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.34 / $641.08 / $767.25
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.77 / $538.50 / $683.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $453.73 / $620.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.11 / $827.13 / $1,629.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.99 / $950.51 / $1,279.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.00 / $471.00 / $2,962.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.29 / $759.12 / $1,455.77
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.47 / $847.35 / $1,047.14