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Pennsylvania rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Facilitymedian $3,802 · 10th–90th $912$8,3180%10%10th90th$3,802Professionalmedian $676 · 10th–90th $537$1,1750%20%40%10th90th$676$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $3,890.45 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $660.69 / $1,122.02
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $891.25 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $741.31 / $1,288.25
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,174.90 / $1,479.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $851.14 / $1,174.90
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $660.69 / $1,258.93
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $1,096.48 / $1,659.59
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $426.58 / $691.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $562.34 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,818.38 / $5,495.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $691.83 / $1,230.27