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Montana rates for HCPCS 21345

Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint

Facilitymedian $1,202 · 10th–90th $1,000–$1,4450%10%20%10th90th$1,202Professionalmedian $1,047 · 10th–90th $646–$1,9050%10%10th90th$1,047$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$630.96 / $891.25 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $870.96 / $1,288.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,318.26 / $1,445.44
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,318.26 / $1,445.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,047.13 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,023.29 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,148.15 / $1,513.56