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Montana rates for HCPCS 21260

Periorbital Osteotomies Bone Grafts Extracranial

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,452.10 / $1,962.48 / $7,344.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.25 / $2,155.25 / $2,155.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,024.10 / $1,917.69 / $2,155.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,065.83 / $1,343.02 / $2,155.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,305.63 / $2,042.73 / $2,850.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,732.85 / $2,245.59 / $3,448.60