go back

Montana rates for HCPCS 21120

Genioplasty; augmentation (autograft, allograft, prosthetic material)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.04 / $995.53 / $3,602.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$805.00 / $805.00 / $805.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.67 / $742.21 / $1,048.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.91 / $558.91 / $842.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.41 / $910.64 / $1,327.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.33 / $1,076.31 / $1,218.16