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Montana rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Facilitymedian $219 · 10th–90th $126–$5010%20%10th90th$219Professionalmedian $135 · 10th–90th $72–$3800%10%10th90th$135$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $407.38 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $134.90 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $177.83 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $144.54 / $213.80
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $213.80 / $245.47
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $213.80 / $245.47
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $190.55 / $239.88