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Montana rates for HCPCS 21073

Manipulation Tmj Therapeutic Require Anesthesia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.74 / $548.70 / $2,057.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.10 / $379.10 / $602.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.10 / $379.10 / $379.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.68 / $391.86 / $646.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.36 / $317.31 / $502.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.08 / $457.03 / $750.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.24 / $615.60 / $698.88