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Montana rates for HCPCS 43502

Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss)

Facilitymedian $2,630 · 10th–90th $1,660–$3,0900%20%40%10th90th$2,630Professionalmedian $1,778 · 10th–90th $1,349–$3,7150%10%20%10th90th$1,778$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,348.96 / $1,584.89 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,089.30 / $4,570.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,630.27 / $2,951.21
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,630.27 / $2,951.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,041.74 / $3,630.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,398.83 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,454.71 / $3,311.31