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Alabama rates for HCPCS 21490

Open Treatment Temporomandibular Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.00 / $1,399.00 / $2,250.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.96 / $861.94 / $1,253.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,270.45 / $6,380.30 / $8,583.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$821.98 / $1,126.00 / $1,328.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.18 / $1,075.53 / $3,133.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.00 / $4,121.00 / $7,227.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.39 / $807.21 / $1,372.56