go back

New Hampshire 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
$2,398.83 / $3,890.45 / $14,791.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,623.41 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,258.93