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Ohio rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.11 / $1,883.00 / $9,516.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$627.29 / $627.29 / $697.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.00 / $1,981.00 / $3,943.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.29 / $36.31 / $44.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.34 / $54.34 / $54.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.00 / $979.00 / $3,398.00