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Montana rates for HCPCS 21275

Secondary revision of orbitocraniofacial reconstruction

Facilitymedian $1,445 · 10th–90th $1,096–$1,7380%50%10th90th$1,445Professionalmedian $1,175 · 10th–90th $813–$2,0890%10%10th90th$1,175$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$812.83 / $1,174.90 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,096.48 / $1,412.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,445.44 / $1,737.80
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,445.44 / $1,737.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,174.90 / $1,698.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,148.15 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,380.38 / $1,778.28