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Montana rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Facilitymedian $2,884 · 10th–90th $2,188–$3,1620%50%10th90th$2,884Professionalmedian $2,291 · 10th–90th $1,585–$4,3650%10%10th90th$2,291$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
$1,584.89 / $2,137.96 / $5,495.41
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,041.74 / $2,691.53
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,884.03 / $3,162.28
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,884.03 / $3,162.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,290.87 / $3,162.28
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,238.72 / $3,467.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,754.23 / $3,467.37