Jaw dislocation reset

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Tmj Dislocation Closed Treat

Payers reporting CPT 21480

Payer pricing summary

Low

$41

Average

$721

Median

$424

High

$4.3k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +30 other terms	413	$240	$374	$823	220%	3–30	$1 – $12.8k
2	Aetna fee schedule · outpatient · +34 other terms	533	$276	$868	$1.8k	206%	2–20	$1 – $21.3k
3	Kaiser fee schedule · outpatient · +23 other terms	103	$315	$474	$641	135%	2–20	$14 – $4.3k
4	First Health fee schedule · outpatient · +22 other terms	40	$256	$983	$2.2k	220%	1–10	$35 – $7.2k
5	Bcbs Al facility · other · outpatient · +4 other terms	3	$163	$163	$8	5%	1–10	$153 – $174
6	UnitedHealthcare fee schedule · outpatient · +36 other terms	593	$247	$628	$1.3k	206%	—	$1 – $17.9k
7	Blue Cross Blue Shield fee schedule · outpatient · +35 other terms	431	$344	$866	$1.7k	192%	—	$1 – $18.0k
8	Cigna case rate · outpatient · +29 other terms	303	$2.9k	$4.6k	$6.2k	135%	—	$1 – $40.7k
9	Molina fee schedule · outpatient · +31 other terms	242	$180	$185	$148	80%	—	$1 – $1.4k
10	WellCare fee schedule · outpatient · +23 other terms	179	$252	$313	$481	154%	—	$52 – $4.3k
11	Anthem fee schedule · outpatient · +29 other terms	147	$221	$317	$743	234%	—	$22 – $6.3k
12	Oscar case rate · outpatient · +22 other terms	137	$2.6k	$2.7k	$755	28%	—	$375 – $7.5k
13	Ambetter facility · fee schedule · outpatient · +20 other terms	100	$441	$556	$921	166%	—	$31 – $8.2k
14	MultiPlan fee schedule · outpatient · +23 other terms	92	$378	$464	$503	108%	—	$23 – $7.3k
15	Aetna Better Health fee schedule · outpatient · +21 other terms	84	$108	$140	$107	77%	—	$25 – $870
16	Devoted facility · fee schedule · outpatient · +15 other terms	79	$235	$356	$697	196%	—	$19 – $4.9k
17	Caresource fee schedule · outpatient · +16 other terms	72	$250	$355	$620	174%	—	$1 – $4.3k
18	Tricare fee schedule · outpatient · +20 other terms	68	$246	$502	$1.1k	214%	—	$29 – $5.1k
19	Optum fee schedule · outpatient · +25 other terms	63	$220	$239	$156	65%	—	$30 – $911
20	Highmark facility · fee schedule · outpatient · +17 other terms	46	$341	$730	$857	117%	—	$30 – $3.8k
21	Medica fee schedule · outpatient · +23 other terms	43	$147	$196	$152	77%	—	$22 – $758
22	Healthcare Highways case rate · outpatient · +4 other terms	39	$5.8k	$6.6k	$5.1k	77%	—	$2.1k – $14.6k
23	Superior Healthplan case rate · outpatient · +5 other terms	38	$948	$934	$81	9%	—	$360 – $948
24	Amerihealth Caritas facility · fee schedule · outpatient · +13 other terms	37	$146	$354	$1.1k	319%	—	$32 – $9.5k
25	Medicare facility · fee schedule · outpatient · +17 other terms	37	$260	$940	$2.7k	290%	—	$28 – $22k

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