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Wisconsin rates for HCPCS 01630

Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified

Facilitymedian $676 · 10th–90th $676–$3,9810%50%90th$676Professionalmedian $245 · 10th–90th $245–$2450%50%100%$245$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
QX
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Aetna
Facility/Professional
Facility
Modifier
QZ
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
QK
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Facility
Modifier
QX
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Facility
Modifier
QY
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Security Health
Facility/Professional
Professional
Modifier
AD
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47