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Upper Back Cordotomy, One Side, Single Operation

Wisconsin rates for HCPCS 63195

Surgery for severe pain that has not responded to other treatment. Part of the bony arch of a vertebra in the chest section of the spine is removed to reach the spinal cord, and the pain-carrying pathway is cut on one side of the cord, relieving pain on the opposite side of the body. It is completed in a single operation.

Rates data updated July 2026.

How much does Upper Back Cordotomy, One Side, Single Operation cost?

$5,370

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $5,370 for this service. The price depends on where it is billed: about $5,888 from a physician practice, and about $4,786 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5,888$5,370 to $7,762
FacilityA hospital or hospital-owned outpatient department$4,786$4,074 to $6,166

How much rates vary

Facilitymedian $4,786 · 10th to 90th $3,631 to $17,783Professionalmedian $5,888 · 10th to 90th $2,291 to $7,762
$100$500$2K$10Kfacility $4,786professional $5,888

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$4,265.80
Typical High
$6,760.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$5,370.32
Typical High
$6,165.95
Medica
Setting
Professional
Modifier
Global
Typical Low
$7,762.47
Median
$7,762.47
Typical High
$7,762.47
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$70.79
Quartz
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,248.07
Typical High
$5,248.07
Quartz
Setting
Professional
Modifier
Global
Typical Low
$5,888.44
Median
$7,762.47
Typical High
$7,762.47
United
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$17,782.79
Typical High
$20,892.96

Where Wisconsin sits

The same service costs 380.2 times more in California than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 9th of 44

$5,370

CA $11,482SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.