go back

Montana rates for HCPCS 21048

Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$962.97 / $1,052.67 / $2,851.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$939.89 / $1,568.46 / $1,938.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$965.65 / $1,568.46 / $2,142.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.82 / $1,788.49 / $1,951.99