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Nebraska rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $6,761 · 10th–90th $1,479–$12,5890%10%10th90th$6,761Professionalmedian $1,259 · 10th–90th $741–$2,8840%10%10th90th$1,259$500.0$1.0K$2.0K$5.0K$10.0K$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
$4,265.80 / $7,585.78 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,258.93 / $4,265.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $8,511.38 / $16,595.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,230.27 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,819.70 / $2,344.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,318.26 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,584.89 / $6,309.57
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,041.74 / $2,454.71
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,778.28 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $6,309.57 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,513.56 / $2,238.72