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Montana rates for HCPCS 64804

Sympathectomy, cervicothoracic

Facilitymedian $2,089 · 10th–90th $1,349–$2,3440%20%40%10th90th$2,089Professionalmedian $1,549 · 10th–90th $1,122–$2,9510%20%10th90th$1,549$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 / $1,479.11 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,288.25 / $1,905.46
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,089.30 / $2,454.71
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,089.30 / $2,454.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,445.44 / $1,995.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,584.89 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,862.09 / $2,290.87