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Montana rates for HCPCS 52301

Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral

Facilitymedian $490 · 10th–90th $490–$6030%20%40%90th$490Professionalmedian $417 · 10th–90th $288–$9550%10%20%10th90th$417$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$288.40 / $371.54 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $446.68 / $489.78
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $501.19 / $602.56
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $501.19 / $602.56
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $562.34
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $338.84 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $489.78 / $776.25