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Mississippi rates for HCPCS 21490

Open Treatment Temporomandibular Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.23 / $1,502.00 / $2,010.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.90 / $861.94 / $1,727.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,371.58 / $1,371.58 / $1,371.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,642.00 / $1,642.00 / $1,642.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.60 / $1,442.59 / $6,486.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.44 / $1,318.88 / $1,946.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.00 / $3,572.00 / $9,515.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.17 / $1,035.56 / $2,156.23