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.
Original text from hospital filings
TM DISLOC TRTMT INIT/SUB
Monroeville, PA
See all hospitals reporting CPT 21480 →Price type
UPMC East’s median price of $1.5k is 361% above the median hospital's median price ($315), higher than 87% of the 2,112 hospitals reporting CPT 21480. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 40 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare unison kids facility · fee schedule · outpatient | $33 | $33 | — | — | — | $33 – $33 |
| 2 | Highmark medicaid facility · fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 3 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $45 | $45 | — | — | — | $45 – $45 |
| 4 | UnitedHealthcare unison advantage non special needs facility · fee schedule · outpatient | $240 | $240 | — | — | — | $240 – $240 |
| 5 | UnitedHealthcare medicare facility · fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 6 | Aetna medicare facility · fee schedule · outpatient | $246 | $246 | $6 | 2% | — | $240 – $252 |
| 7 | Highmark medicare facility · fee schedule · outpatient | $247 | $247 | — | — | — | $247 – $247 |
| 8 | Amerihealth Caritas medicare facility · fee schedule · outpatient | $247 | $247 | — | — | — | $247 – $247 |
| 9 | Cigna medicare facility · fee schedule · outpatient | $247 | $247 | — | — | — | $247 – $247 |
| 10 | UnitedHealthcare unison advantage special needs facility · fee schedule · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 11 | Highmark complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · fee schedule · outpatient | $550 | $550 | — | — | — | $550 – $550 |
| 12 | Highmark managed care - social mission facility · fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 13 | UnitedHealthcare compass exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 14 | UnitedHealthcare compass exchange facility · percent of total billed charges · inpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 15 | Aetna neighborhood network facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 16 | Aetna neighborhood network facility · percent of total billed charges · inpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 17 | Aetna ebr fi facility · percent of total billed charges · inpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 18 | Aetna ebr fi facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 19 | Aetna home depot employer group facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 20 | Aetna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 21 | Cigna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 22 | Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 23 | UnitedHealthcare all business facility · percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 24 | Aetna home depot employer group facility · percent of total billed charges · inpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 25 | Aetna ebr aso facility · percent of total billed charges · inpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
Last updated: Mar 6, 2026
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