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Wyoming 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
Professional
Modifier
Low / Median / High Price
$785.35 / $962.17 / $1,348.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,304.00 / $1,304.00 / $1,304.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,499.00 / $1,834.00 / $2,775.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.25 / $1,527.50 / $2,741.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $5,606.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.92 / $1,638.41 / $2,729.46