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Minnesota rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $147.91 / $524.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $478.63 / $1,096.48
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$549.54 / $1,023.29 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $537.03 / $1,288.25
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $512.86 / $1,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $138.04 / $562.34
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,819.70 / $3,467.37