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Montana rates for HCPCS 21208

Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,698.24 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,412.54 / $2,570.40
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $2,818.38 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,445.44 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,621.81 / $3,090.30