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Montana rates for HCPCS 15841

Graft for facial nerve paralysis; free muscle graft (including obtaining graft)

Facilitymedian $3,090 · 10th–90th $2,512–$3,7150%20%40%10th90th$3,090Professionalmedian $2,754 · 10th–90th $1,738–$6,0260%10%20%10th90th$2,754$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
$1,737.80 / $2,454.71 / $6,456.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,691.53 / $3,019.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,090.30 / $3,715.35
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,090.30 / $3,715.35
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,905.46 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,862.09 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,818.38 / $3,311.31