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Michigan rates for HCPCS 21242

Arthroplasty, temporomandibular joint, with allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,280.77 / $4,933.00 / $5,757.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$907.28 / $1,280.77 / $1,330.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.39 / $5,597.88 / $7,584.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.27 / $1,689.41 / $2,620.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$745.13 / $1,178.68 / $2,209.23
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.27 / $4,933.00 / $5,757.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.48 / $1,129.71 / $1,661.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.56 / $690.80 / $1,141.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,500.00 / $8,702.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,024.49 / $1,215.50 / $1,704.35