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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
$29.77 / $148.91 / $2,042.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.87 / $420.42 / $838.05
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$537.72 / $815.83 / $1,430.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.02 / $508.83 / $1,224.06
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$291.68 / $465.19 / $963.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.54 / $131.16 / $383.14
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,230.04 / $1,230.04 / $1,230.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.00 / $1,580.95 / $3,584.00