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Colorado rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $5,495.41 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $912.01 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $6,456.54 / $10,964.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,148.15 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,995.26 / $6,309.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,148.15 / $1,905.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,023.29 / $3,630.78
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $724.44 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $12,022.64 / $18,620.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,174.90 / $1,995.26