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Georgia rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $4,266 · 10th–90th $1,202–$7,4130%5%10%10th90th$4,266Professionalmedian $1,000 · 10th–90th $724–$1,8620%10%10th90th$1,000$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,370.32 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,570.40 / $5,888.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,380.38 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $2,089.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,023.29 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $6,165.95 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,174.90 / $1,819.70