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Pennsylvania rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $1,738 · 10th–90th $240–$7,2440%5%10%10th90th$1,738$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$239.88 / $1,905.46 / $7,762.47
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,318.26 / $1,479.11 / $1,698.24
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $2,187.76 / $3,467.37
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $489.78 / $1,122.02
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$363.08 / $977.24 / $1,659.59
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $1,548.82 / $3,019.95
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $1,584.89 / $6,165.95
Martin's Point
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $147.91 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $676.08 / $3,890.45