go back

Utah rates for HCPCS 21485

Closed Tx Temporomandibular Dislc Comp 1st/Sbsq

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.93 / $3,038.00 / $4,626.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.04 / $933.67 / $3,915.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.57 / $954.50 / $1,741.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.74 / $550.93 / $885.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,237.82 / $2,891.57 / $4,213.85
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,045.02 / $1,389.10 / $1,720.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,689.00 / $2,312.00 / $4,640.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.97 / $894.96 / $1,521.17