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Arkansas rates for HCPCS 21485

Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$682.31 / $1,083.00 / $3,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.11 / $748.58 / $985.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,411.79 / $1,411.79 / $1,694.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.35 / $1,088.41 / $1,328.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,734.43 / $1,734.43 / $1,734.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.72 / $1,054.99 / $1,456.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.00 / $1,230.00 / $2,539.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.78 / $880.48 / $1,704.79