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Montana rates for HCPCS 15770

Graft; derma-fat-fascia

Facilitymedian $1,175 · 10th–90th $1,023–$1,3800%50%10th90th$1,175Professionalmedian $692 · 10th–90th $186–$1,6980%10%20%10th90th$692$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
$186.21 / $645.65 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,071.52 / $1,122.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,174.90 / $1,380.38
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,174.90 / $1,380.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $1,202.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $691.83 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,122.02 / $1,230.27