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South Dakota rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $148 · 10th–90th $29–$2,2910%10%10th90th$148Professionalmedian $145 · 10th–90th $52–$2690%10%10th90th$145$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$28.84 / $147.91 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $131.83 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $72.44 / $245.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $144.54 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83