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Montana rates for HCPCS 21215

Graft, bone; mandible (includes obtaining graft)

Facilitymedian $4,467 · 10th–90th $1,349–$7,2440%10%20%10th90th$4,467Professionalmedian $3,388 · 10th–90th $794–$7,9430%10%10th90th$3,388$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $3,388.44 / $7,943.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,513.56 / $6,456.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $6,606.93 / $7,244.36
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $6,606.93 / $7,244.36
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,778.28 / $6,606.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,548.82 / $8,128.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,019.95 / $7,413.10