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Minnesota rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $5,129 · 10th–90th $1,202–$12,0230%10%10th90th$5,129Professionalmedian $1,738 · 10th–90th $794–$2,8840%5%10%10th90th$1,738$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
$794.33 / $794.33 / $5,011.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $851.14 / $1,479.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $7,585.78 / $19,498.45
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,995.26 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,884.03 / $6,918.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,398.83 / $3,548.13
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,818.38 / $5,495.41
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,995.26 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,621.81 / $8,317.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,621.81 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,079.46 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,659.59 / $2,951.21