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Montana rates for HCPCS 25905

Amputation, forearm, through radius and ulna; open, circular (guillotine)

Facilitymedian $1,202 · 10th–90th $933–$1,3180%50%10th90th$1,202Professionalmedian $1,023 · 10th–90th $676–$1,7780%10%10th90th$1,023$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
$676.08 / $977.24 / $1,949.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $954.99 / $1,174.90
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,230.27 / $1,318.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,230.27 / $1,318.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,047.13 / $1,548.82
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $954.99 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,148.15 / $1,445.44