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Missouri 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
$851.53 / $3,131.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.49 / $879.08 / $1,261.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.00 / $669.09 / $1,138.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.38 / $979.43 / $1,650.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$667.16 / $1,139.84 / $2,672.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.60 / $1,276.19 / $7,097.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,216.00 / $2,306.00 / $3,071.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.99 / $1,029.53 / $1,780.50