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Montana rates for HCPCS 21206

Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.15 / $1,420.97 / $6,124.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.16 / $1,524.82 / $2,079.48
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$925.53 / $1,524.82 / $2,142.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,586.10 / $1,909.36 / $2,249.27