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Delaware 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
$3,949.00 / $3,949.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.58 / $820.60 / $1,006.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$721.24 / $721.24 / $721.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.85 / $738.35 / $1,298.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,320.00 / $1,320.00 / $1,320.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.16 / $646.02 / $2,003.74