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Wisconsin rates for HCPCS 51725

Simple cystometrogram (CMG) (eg, spinal manometer)

Facilitymedian $170 · 10th–90th $76–$3090%10%20%10th90th$170Professionalmedian $339 · 10th–90th $214–$1,0000%5%10%10th90th$339$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$75.86 / $154.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $309.03 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $436.52 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$194.98 / $223.87 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $741.31 / $831.76
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $512.86 / $616.60
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $407.38 / $1,258.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $263.03
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $524.81 / $776.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $501.19 / $776.25
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$190.55 / $467.74 / $467.74
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $1,023.29 / $1,698.24
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,380.38 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $363.08 / $912.01