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Montana rates for HCPCS 21395

Optx Orb Floor Blwt Fx Pri/Bital Appr W/Bone Grf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,070.29 / $1,415.54 / $5,331.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,589.49 / $1,589.49 / $1,589.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.06 / $1,589.49 / $1,686.64
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$785.40 / $1,029.72 / $1,589.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.59 / $1,589.49 / $2,093.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,448.26 / $1,642.48 / $1,858.93