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Removal Of A Noncancerous Growth From Upper Jaw

Montana rates for HCPCS 21049

Surgery to remove a noncancerous growth or cyst from the upper jaw bone. Because of the size or position of the growth, the surgeon cuts through and removes a section of the jaw bone along with it rather than simply scooping it out.

Rates data updated July 2026.

Professionalmedian $1,778 · 10th–90th $1,072$3,0900%10%20%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
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,698.24
Typical High
$6,309.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,659.59
Typical High
$2,041.74
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$1,995.26
Typical High
$2,511.89
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,659.59
Typical High
$2,454.71
United
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,995.26
Typical High
$2,344.23