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Montana rates for HCPCS 21079

Impression & Preparation Interim Obturator Prost

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,215.72 / $2,074.57 / $8,093.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,832.41 / $1,832.41 / $2,289.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,149.47 / $1,945.93 / $2,813.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,351.75 / $2,064.46 / $2,961.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,133.84 / $2,571.82 / $2,830.41