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Delaware rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $794.33 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $954.99 / $1,621.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $954.99 / $1,584.89