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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
$676.08 / $1,071.52 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $851.14 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,000.00 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $977.24 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $1,445.44 / $4,365.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $812.83 / $1,445.44