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Montana rates for HCPCS 50520

Closure of nephrocutaneous or pyelocutaneous fistula

Facilitymedian $1,995 · 10th–90th $1,738–$2,2390%50%10th90th$1,995Professionalmedian $1,479 · 10th–90th $1,175–$2,8840%20%10th90th$1,479$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
$1,174.90 / $1,479.11 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,737.80 / $1,819.70
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,995.26 / $2,238.72
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,995.26 / $2,238.72
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,479.11 / $2,238.72
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,202.26 / $2,570.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,905.46 / $3,235.94