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Maryland rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $67.61
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $331.13 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $208.93 / $302.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.51 / $40.74 / $114.82