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Arizona rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.00 / $2,202.00 / $5,506.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$896.00 / $896.00 / $896.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$412.80 / $1,640.88 / $2,700.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.30 / $123.24 / $1,117.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$683.00 / $1,423.00 / $2,114.00