go back

Montana rates for HCPCS 21450

Closed Tx Mandibular Fracture W/O Manipulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.44 / $887.64 / $3,126.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.20 / $758.20 / $758.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$419.49 / $682.38 / $947.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.72 / $497.87 / $758.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.23 / $819.90 / $1,223.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.67 / $953.51 / $1,052.15