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Montana rates for HCPCS 41872

Gingivoplasty, each quadrant (specify)

Facilitymedian $550 · 10th–90th $372–$8710%10%20%10th90th$550Professionalmedian $457 · 10th–90th $288–$8710%10%10th90th$457$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $446.68 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $457.09 / $977.24
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $645.65 / $831.76
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $645.65 / $831.76
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $501.19 / $933.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $630.96 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $562.34 / $851.14