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Montana rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $148 · 10th–90th $52–$2630%20%10th90th$148$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $162.18 / $251.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $120.23 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80