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Indiana rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $8,128 · 10th–90th $1,738–$11,2200%10%10th90th$8,128Professionalmedian $851 · 10th–90th $724–$1,6600%20%10th90th$851$200.0$500.0$1.0K$2.0K$5.0K$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
$1,122.02 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $794.33 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $8,317.64 / $10,471.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $912.01 / $1,479.11
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $812.83 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,023.29 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $954.99 / $1,659.59