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Kansas rates for HCPCS 21490

Open Treatment Temporomandibular Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,070.00 / $4,919.00 / $12,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$727.96 / $791.58 / $1,262.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,083.55 / $1,274.76 / $1,274.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.00 / $505.00 / $505.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.67 / $1,135.19 / $1,881.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$791.58 / $1,287.83 / $8,419.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.74 / $1,107.76 / $6,294.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,967.00 / $4,960.00 / $11,618.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$883.59 / $1,029.42 / $1,441.12