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Montana rates for HCPCS 21125

Augmentation, mandibular body or angle; prosthetic material

Facilitymedian $2,818 · 10th–90th $1,148–$5,1290%20%10th90th$2,818Professionalmedian $2,399 · 10th–90th $676–$5,4950%5%10%10th90th$2,399$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
$676.08 / $2,398.83 / $5,495.41
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,288.25 / $4,168.69
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $4,365.16 / $5,128.61
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $4,365.16 / $5,128.61
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $1,621.81 / $5,495.41
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,318.26 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,454.71 / $5,128.61