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Wisconsin rates for HCPCS 0494T

Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold preservation of the allograft prior to implantation, when performed

Facilitymedian $12,589 · 10th–90th $6,918–$20,4170%10%10th90th$12,589Professionalmedian $363 · 10th–90th $200–$1,1220%10%10th90th$363$100.0$500.0$2.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $302.00 / $363.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $12,882.50 / $20,417.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $602.56 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $954.99
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $630.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $338.84 / $630.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $575.44 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $758.58 / $1,047.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,995.26
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,238.72 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $16,982.44 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $524.81 / $1,380.38