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Montana rates for HCPCS 21210

Graft Bone Nasal/Maxillary/Malar Areas

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.95 / $2,814.78 / $10,765.50
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
$1,195.67 / $1,195.67 / $1,195.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$770.00 / $1,466.64 / $3,739.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$598.91 / $1,195.67 / $2,753.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.32 / $1,730.08 / $3,743.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,720.85 / $3,334.67 / $3,781.60