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Montana rates for HCPCS 42975

Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic

Facilitymedian $191 · 10th–90th $166–$5,0120%50%10th90th$191Professionalmedian $148 · 10th–90th $100–$2,5120%20%10th90th$148$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$0.89 / $2,511.89 / $5,011.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $151.36
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $194.98
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $194.98
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $154.88 / $194.98
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $147.91 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $3,630.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $288.40