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California rates for HCPCS 21480

Closed Tx Temporomandibular Dislocation 1st/Sbsq

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.00 / $4,056.00 / $16,109.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,441.76 / $1,968.28 / $1,968.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,723.00 / $4,464.00 / $8,976.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $5,170.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.20 / $253.65 / $1,487.00
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.97 / $70.73 / $199.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.18 / $128.00 / $273.56
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$259.77 / $259.77 / $12,000.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.75 / $100.67 / $221.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$545.00 / $1,506.00 / $6,920.00