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Louisiana rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $2,692 · 10th–90th $891–$6,6070%5%10th90th$2,692Professionalmedian $977 · 10th–90th $724–$1,4130%10%20%10th90th$977$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
$758.58 / $2,041.74 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $5,754.40 / $10,715.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,071.52 / $1,258.93
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,148.15 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $5,011.87 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $933.25 / $1,479.11