go back

Idaho rates for HCPCS 21242

Arthroplasty Temporomandibular Jt W/Allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,415.00 / $4,500.00 / $8,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,029.09 / $1,424.84 / $2,096.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,502.28 / $3,502.28 / $3,512.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,140.63 / $1,540.09 / $1,817.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.16 / $1,838.34 / $2,529.94
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,627.84 / $1,775.83 / $2,400.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,422.85 / $1,790.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,660.78 / $14,097.25 / $17,807.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.74 / $2,016.16 / $2,400.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,100.00 / $10,120.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,109.59 / $1,489.21 / $2,160.81