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Ohio 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
$1,548.82 / $7,079.46 / $12,022.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,365.16 / $16,982.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62
SummaCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $7,244.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $6,760.83 / $11,220.18