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Missouri rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $1,660 · 10th–90th $105$5,6230%5%10th90th$1,660$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $1,819.70 / $5,754.40
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $131.83 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $549.54 / $1,584.89