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Wisconsin rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Facilitymedian $7,586 · 10th–90th $479–$15,8490%5%10th90th$7,586Professionalmedian $891 · 10th–90th $501–$1,5490%10%10th90th$891$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$389.05 / $724.44 / $6,456.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $10,232.93 / $17,378.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,412.54 / $2,238.72
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $524.81 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $537.03 / $6,918.31
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $5,754.40 / $7,762.47
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $891.25 / $1,548.82
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $16,595.87 / $16,595.87
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $7,585.78 / $9,772.37