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Michigan rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $4,898 · 10th–90th $2,630–$6,9180%20%10th90th$4,898Professionalmedian $933 · 10th–90th $724–$1,8200%20%10th90th$933$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
$4,073.80 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $831.76 / $1,412.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,096.48 / $2,238.72
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,073.80 / $5,754.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,023.29 / $1,778.28
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,047.13 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $6,025.60 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $1,412.54