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Montana rates for HCPCS 21407

Open treatment of fracture of orbit, except blowout; with implant

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.95 / $908.12 / $3,403.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,015.85 / $1,015.85 / $1,015.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.60 / $1,015.85 / $1,077.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.30 / $698.92 / $1,015.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.03 / $1,015.85 / $1,329.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.56 / $1,042.75 / $1,182.72