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Washington rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $234 · 10th–90th $44$6,4570%5%10th90th$234$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
$61.66 / $691.83 / $17,782.79
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $630.96 / $1,288.25
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$645.65 / $933.25 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $467.74 / $562.34
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $114.82 / $346.74
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$281.84 / $912.01 / $1,621.81
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $223.87 / $275.42
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $194.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $660.69 / $1,288.25
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$645.65 / $977.24 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $851.14 / $1,949.84