go back

Montana rates for HCPCS 21083

Impression and custom preparation; palatal lift prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,548.82 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,698.24 / $2,187.76
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $2,344.23 / $2,630.27
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,344.23 / $2,630.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,819.70 / $2,754.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,819.70 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,041.74 / $2,630.27