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Montana rates for HCPCS 21497

Interdental wiring, for condition other than fracture

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.19 / $746.23 / $3,104.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$928.04 / $928.04 / $1,116.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$927.51 / $927.51 / $927.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.22 / $834.76 / $1,127.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.28 / $596.52 / $927.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.91 / $980.76 / $1,465.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$860.06 / $860.06 / $2,962.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$921.20 / $1,136.81 / $1,254.40