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Montana rates for HCPCS D7311

Alveoloplasty In Conjunction With Extractions - One To Three Teeth Or Tooth Spaces, Per Quadrant

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.94 / $138.94 / $138.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.22 / $156.22 / $156.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.11 / $208.68 / $301.00