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Montana rates for HCPCS 53454

Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume

Facilitymedian $68 · 10th–90th $46–$720%50%10th90th$68Professionalmedian $29 · 10th–90th $23–$790%20%10th90th$29$20.0$50.0$100.0$200.0$500.0

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
$22.91 / $28.18 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $67.61 / $69.18
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $67.61 / $69.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $45.71 / $109.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $79.43 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $85.11