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Florida rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$814.22 / $4,003.00 / $11,550.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.64 / $814.22 / $1,084.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.00 / $1,389.94 / $1,654.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$667.44 / $1,081.81 / $1,833.17
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,979.00 / $12,804.00 / $23,031.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.38 / $771.83 / $931.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.45 / $591.50 / $1,003.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,581.00 / $10,309.00 / $15,888.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.09 / $928.56 / $1,576.55
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.84 / $615.84 / $779.83