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Montana rates for HCPCS 21184

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm

Facilitymedian $4,169 · 10th–90th $3,162–$4,7860%50%10th90th$4,169Professionalmedian $3,548 · 10th–90th $2,399–$6,1660%10%20%10th90th$3,548$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
$2,398.83 / $3,467.37 / $6,760.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,162.28 / $4,073.80
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,265.80 / $4,786.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,265.80 / $4,786.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $5,128.61
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,388.44 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $4,073.80 / $5,248.07