go back

North Carolina 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
$1,023.79 / $7,186.00 / $12,317.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.70 / $748.70 / $5,006.99
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.79 / $1,359.39 / $2,256.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,183.00 / $12,216.00 / $19,066.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,812.26 / $16,547.20 / $26,542.00