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South Carolina rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $8,710 · 10th–90th $1,000–$16,5960%10%20%10th90th$8,710Professionalmedian $912 · 10th–90th $708–$1,7380%20%10th90th$912$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
$2,454.71 / $9,120.11 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,737.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $9,332.54 / $17,378.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $912.01 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $1,737.80
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,148.15 / $1,949.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $14,791.08 / $24,547.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $954.99 / $1,479.11