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Montana rates for HCPCS 21120

Genioplasty; augmentation (autograft, allograft, prosthetic material)

Facilitymedian $933 · 10th–90th $759–$1,2020%20%10th90th$933Professionalmedian $891 · 10th–90th $513–$1,6600%10%10th90th$891$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$512.86 / $758.58 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $724.44 / $1,000.00
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $1,202.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $1,202.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $812.83 / $1,174.90
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $812.83 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $1,258.93