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Montana rates for HCPCS 15842

Graft for facial nerve paralysis; free muscle flap by microsurgical technique

Facilitymedian $4,571 · 10th–90th $3,802–$5,2480%20%40%10th90th$4,571Professionalmedian $4,169 · 10th–90th $2,630–$8,9130%10%10th90th$4,169$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
$2,630.27 / $3,715.35 / $13,182.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,073.80 / $4,570.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,677.35 / $5,248.07
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,677.35 / $5,248.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,570.40 / $5,011.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,884.03 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,365.16 / $5,011.87