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Nebraska rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$663.70 / $4,778.89 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.32 / $663.70 / $3,104.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,937.84 / $7,809.88 / $15,106.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$577.44 / $984.26 / $1,340.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.07 / $986.07 / $986.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$787.63 / $1,379.79 / $2,079.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.32 / $1,017.52 / $1,843.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$843.83 / $1,431.27 / $4,376.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.07 / $1,320.95 / $1,853.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.00 / $1,450.48 / $1,914.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,679.00 / $3,167.00 / $7,772.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$843.83 / $1,441.00 / $1,817.48