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Nebraska 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
$908.15 / $4,778.89 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.01 / $908.15 / $3,915.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.63 / $3,041.74 / $5,883.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.44 / $1,315.56 / $1,810.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.07 / $986.07 / $986.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.95 / $1,846.36 / $2,506.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.61 / $1,298.52 / $1,843.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$999.18 / $1,623.67 / $5,805.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.07 / $1,566.04 / $2,388.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.98 / $1,711.98 / $2,506.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,044.00 / $3,726.00 / $7,934.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.98 / $1,790.20 / $2,331.42