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Montana rates for HCPCS 0495T

Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; first two hours in sterile field

Facilitymedian $562 · 10th–90th $417–$5750%50%10th90th$562Professionalmedian $339 · 10th–90th $229–$5500%50%10th90th$339$100.0$200.0$500.0$1.0K

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
$229.09 / $338.84 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $512.86
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $562.34 / $575.44
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $562.34 / $575.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $380.19 / $602.56
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $457.09 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $891.25