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West Virginia 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
$1,011.55 / $1,400.00 / $2,300.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,012.41 / $1,107.15 / $1,323.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,178.82 / $1,178.82 / $1,178.82