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Montana rates for HCPCS 21127

Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $3,548.13 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,513.56 / $6,309.57
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $6,606.93 / $7,413.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,513.56 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,089.30 / $7,244.36