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Virginia rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $288 · 10th–90th $35–$5,2480%5%10th90th$288Professionalmedian $191 · 10th–90th $112–$3240%10%20%10th90th$191$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $1,479.11 / $5,888.44
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,235.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,570.40 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $263.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $323.59
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $100.00 / $208.93
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $41.69 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,047.13 / $2,344.23