go back

Vermont rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.03 / $710.39 / $854.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.80 / $1,060.08 / $1,572.62
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.60 / $1,048.95 / $1,572.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.99 / $971.66 / $2,871.44