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Tennessee rates for HCPCS 21490

Open treatment of temporomandibular dislocation

Facilitymedian $3,388 · 10th–90th $1,230–$7,5860%5%10%10th90th$3,388Professionalmedian $955 · 10th–90th $708–$1,9950%20%10th90th$955$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
$891.25 / $2,454.71 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $1,778.28
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $4,168.69 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,318.26 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,174.90 / $1,778.28
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,471.29 / $10,471.29 / $45,708.82
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,071.52 / $1,698.24