go back

Montana rates for HCPCS 21206

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,412.54 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,479.11 / $2,041.74
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,698.24 / $2,454.71
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,380.38 / $2,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,905.46 / $2,187.76