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Illinois rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $2,884 · 10th–90th $1,023–$8,5110%5%10%10th90th$2,884Professionalmedian $1,023 · 10th–90th $724–$1,8200%10%10th90th$1,023$50.0$200.0$1.0K$5.0K$20.0K

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
$1,023.29 / $2,884.03 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $933.25 / $1,737.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,128.61 / $16,595.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,122.02 / $1,819.70
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,348.96 / $4,168.69
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $5,370.32 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $1,737.80