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Minnesota rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.53 / $744.57 / $2,525.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.59 / $726.71 / $1,129.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.98 / $3,409.81 / $6,167.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.74 / $1,746.66 / $2,490.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,794.78 / $2,546.54 / $6,126.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,221.35 / $2,005.58 / $3,071.71
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,631.62 / $2,328.14 / $4,823.64
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,140.52 / $1,801.73 / $2,800.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.15 / $1,139.77 / $1,967.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.73 / $1,458.07 / $4,376.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.00 / $2,296.00 / $6,275.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.58 / $1,434.69 / $2,644.45