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Montana rates for HCPCS 21408

Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$956.23 / $1,267.05 / $4,765.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,425.97 / $1,425.97 / $1,425.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$769.90 / $1,425.97 / $1,503.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$706.42 / $971.32 / $1,425.97
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$865.36 / $1,425.97 / $1,872.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,229.98 / $1,490.60 / $1,663.86