go back

Montana rates for HCPCS 50930

Closure of ureterovisceral fistula (including visceral repair)

Facilitymedian $1,905 · 10th–90th $1,738–$2,0890%50%10th90th$1,905Professionalmedian $1,660 · 10th–90th $1,122–$2,8180%10%10th90th$1,660$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
$1,122.02 / $1,445.44 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $1,862.09
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,905.46 / $2,089.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,905.46 / $2,089.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,698.24 / $2,187.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,258.93 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,949.84 / $3,019.95