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Utah rates for HCPCS 21480

Closed Tx Temporomandibular Dislocation 1st/Sbsq

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.22 / $704.96 / $4,312.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.97 / $447.13 / $651.60
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$511.46 / $670.70 / $977.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.00 / $4,445.00 / $4,912.00