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Utah rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $2,239 · 10th–90th $126–$4,5710%10%10th90th$2,239Professionalmedian $186 · 10th–90th $44–$3160%10%10th90th$186$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$125.89 / $3,019.95 / $4,570.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $467.74 / $724.44
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,071.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $186.21 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61