go back

Indiana rates for HCPCS 21240

Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$993.61 / $2,553.58 / $14,063.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,641.00 / $8,512.00 / $16,307.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$981.58 / $1,347.26 / $2,020.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,909.74 / $3,909.74 / $4,634.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,472.00 / $10,113.00 / $15,750.00