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Montana rates for HCPCS 21049

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

Professionalmedian $1,778 · 10th–90th $1,148–$2,8840%10%10th90th$1,778$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,698.24 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,548.82 / $1,995.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,995.26 / $2,511.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,659.59 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,995.26 / $2,511.89