go back

Vermont rates for HCPCS 21490

Open Treatment Temporomandibular Dislocation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$928.16 / $1,131.94 / $1,131.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.11 / $1,440.32 / $1,881.07
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.11 / $1,339.54 / $1,881.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,135.78 / $1,183.39 / $3,434.63