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Montana rates for HCPCS 50920

Closure of ureterocutaneous fistula

Facilitymedian $1,514 · 10th–90th $1,380–$1,6980%50%10th90th$1,514Professionalmedian $1,259 · 10th–90th $891–$2,2910%10%20%10th90th$1,259$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
$891.25 / $1,148.15 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,380.38 / $1,479.11
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,513.56 / $1,698.24
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,513.56 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,258.93 / $1,737.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,000.00 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $2,398.83