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Wisconsin rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Facilitymedian $2,399 · 10th–90th $141–$4,8980%10%10th90th$2,399Professionalmedian $191 · 10th–90th $59–$5620%10%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $234.42 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,090.30 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $446.68 / $707.95
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $147.91 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $147.91 / $1,584.89
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $891.25 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $190.55 / $562.34
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $501.19 / $1,995.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,584.89 / $2,187.76