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Minnesota 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
$831.76 / $1,023.29 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $870.96 / $1,513.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $4,168.69 / $10,471.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,995.26 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,630.78 / $8,709.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,691.53 / $4,073.80
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $3,467.37 / $6,918.31
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,398.83 / $3,890.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $1,380.38 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,548.82 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $3,467.37 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,380.38 / $2,951.21