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Montana rates for HCPCS 40845

Vestibuloplasty; complex (including ridge extension, muscle repositioning)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,819.70 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,905.46 / $2,454.71
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,511.89 / $2,754.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,511.89 / $2,754.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,949.84 / $2,691.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,659.59 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,238.72 / $3,467.37