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Montana rates for HCPCS 21188

Rcnstj Mdfc Oth/Thn Lefort Osteot & Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,649.16 / $2,297.31 / $8,643.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,473.89 / $2,473.89 / $2,473.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,342.55 / $2,473.89 / $2,624.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.68 / $1,682.56 / $2,473.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.69 / $2,473.89 / $3,273.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,221.56 / $2,661.90 / $2,951.59