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Rhode Island rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,754.23 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $724.44 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $707.95 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $891.25 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $4,073.80 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $776.25 / $1,348.96