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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
$676.08 / $831.76 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $1,318.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,691.53 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,445.44 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,288.25 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,412.54 / $2,754.23