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Revita

Montana rates for HCPCS Q4180

Revita, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Revita cost?

$661

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $661 from a physician practice, and about $437 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$661$398 to $724
FacilityA hospital or hospital-owned outpatient department$437$398 to $832

How much rates vary

Facilitymedian $437 · 10th to 90th $182 to $1,862Professionalmedian $661 · 10th to 90th $126 to $1,175
$100$1K$10K$100Kfacility $437professional $661

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$724.44
Typical High
$812.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$1,174.90
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$1,174.90
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$398.11
Typical High
$1,202.26
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$398.11
Typical High
$1,202.26
Providence
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$660.69
Typical High
$1,174.90
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$1,819.70
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana sits

The same service costs 3.9 times more in Wyoming than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 16th of 51

$661

WY $708NC $182

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.