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New Mexico rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $1,349 · 10th–90th $933–$8,7100%20%10th90th$1,349Professionalmedian $933 · 10th–90th $724–$1,5490%20%10th90th$933$50.0$200.0$1.0K$5.0K

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
$1,122.02 / $1,548.82 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,148.15 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $223.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,148.15 / $1,819.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,288.25 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $9,120.11 / $16,982.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,230.27 / $1,698.24