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Montana rates for HCPCS 21050

Condylectomy, temporomandibular joint (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.71 / $1,249.55 / $4,692.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.72 / $1,359.72 / $1,359.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.93 / $1,359.72 / $1,413.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$673.15 / $925.58 / $1,359.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.54 / $1,359.72 / $1,788.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,285.71 / $1,462.18 / $2,229.06