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Michigan 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
$1,335.64 / $4,933.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,222.14 / $15,518.90 / $21,025.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,108.01 / $1,335.64 / $6,906.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,500.00 / $8,702.00 / $10,652.00