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Wisconsin rates for HCPCS 40701

Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure

Facilitymedian $10,233 · 10th–90th $4,074–$16,9820%5%10%10th90th$10,233Professionalmedian $1,698 · 10th–90th $1,096–$4,7860%10%10th90th$1,698$50.0$200.0$1.0K$5.0K$20.0K

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
$1,288.25 / $2,398.83 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,288.25 / $2,951.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,238.72 / $6,760.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,548.13 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,398.83 / $4,897.79
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $3,388.44 / $5,754.40
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,884.03 / $3,630.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $3,467.37 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,949.84 / $6,456.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,548.82
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,951.21 / $4,570.88
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,511.89 / $3,890.45
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $16,595.87 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,137.96 / $8,709.64
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,888.44 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,819.70 / $5,011.87