Nose fracture repair - non-surgical with fixation
What goes into a price?
Negotiated prices across insurers
Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the Nose fracture repair - non-surgical with fixation Standard Service Package (SSP MS025). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS J3490 | Facility Fee | Pharmaceuticals without Categories |
| HCPCS J7030 | Facility Fee | Intravenous infusion of 1000cc of normal saline |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2250 | Facility Fee | Intramuscular injection of 1mg midazolam hydrochloride |
| HCPCS 21320 | Facility Fee | Closed Reduction of Nasal Bone Fracture with Fixation |
| HCPCS 21320 | Professional Fee | Closed Reduction of Nasal Bone Fracture with Fixation |
| Revenue Code 250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| HCPCS J2001 | Facility Fee | Injection of 10mg Lidocaine Hcl via IV Infusion |