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Montana rates for HCPCS 21110

Application of interdental fixation device for conditions other than fracture or dislocation, includes removal

Facilitymedian $1,318 · 10th–90th $955–$1,6600%20%40%10th90th$1,318Professionalmedian $1,148 · 10th–90th $708–$2,1880%10%20%10th90th$1,148$100.0$500.0$2.0K$10.0K$50.0K

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,047.13 / $2,570.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $912.01 / $1,348.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,318.26 / $1,548.82
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,318.26 / $1,548.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,023.29 / $1,412.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,122.02 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,202.26 / $1,584.89