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Montana rates for HCPCS D7210

Extraction, Erupted Tooth Requiring Removal Of Bone And/Or Sectioning Of Tooth, And Including Elevation Of Mucoperiosteal Flap If Indicated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.21 / $101.40 / $111.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $150.00 / $150.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$172.04 / $172.04 / $172.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.25 / $168.40 / $242.90