go back

Hawaii rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$864.50 / $2,747.00 / $2,898.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.89 / $158.94 / $187.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,078.00 / $1,078.00