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Kentucky rates for HCPCS 21242

Arthroplasty, temporomandibular joint, with allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $2,818.38 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,023.29 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $4,466.84 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,023.29 / $1,412.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,258.93 / $1,737.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,258.93 / $1,513.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,659.59 / $5,754.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $4,677.35 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,202.26 / $1,995.26