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North Dakota rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.22 / $837.22 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$768.90 / $837.22 / $922.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,567.31 / $1,738.82 / $2,045.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$992.64 / $1,983.17 / $2,641.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.22 / $1,179.03 / $1,423.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$878.16 / $1,629.92 / $2,179.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$857.85 / $1,555.59 / $2,179.98