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Dye Injection Into the Jaw Joint for Imaging

Wisconsin rates for HCPCS 21116

Injects contrast dye into the joint in front of the ear where the lower jaw meets the skull, so that X-ray images can show the joint space, the cushioning disc, and any leak between compartments. This covers the injection itself; the imaging is done separately. The skin is numbed and the needle is placed with the jaw positioned to open the joint space.

Facilitymedian $661 · 10th–90th $48$2,0420%10%10th90th$661Professionalmedian $148 · 10th–90th $43$5130%10%10th90th$148$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$218.78
Typical High
$1,905.46
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$144.54
Typical High
$331.13
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,584.89
Typical High
$1,584.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$109.65
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$676.08
Typical High
$1,071.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$204.17
Typical High
$1,000.00
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$208.93
Typical High
$3,162.28
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$158.49
Typical High
$575.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$208.93
Typical High
$1,513.56
Medica
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$446.68
Typical High
$1,905.46
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$891.25
Typical High
$2,344.23
Network Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$316.23
Typical High
$741.31
Quartz
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$239.88
Typical High
$724.44
Quartz
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$1,288.25
Typical High
$1,288.25
Quartz
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$812.83
Typical High
$1,949.84
Security Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$741.31
Security Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$309.03
Typical High
$1,380.38
United
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,584.89
Typical High
$2,187.76
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$204.17
Typical High
$707.95