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Kansas rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $4,570.88 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $831.76 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,122.02 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,348.96 / $11,748.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $6,309.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,715.35 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,023.29 / $1,445.44