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Wisconsin rates for HCPCS 74190

Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation

Facilitymedian $56 · 10th–90th $32$1290%10%20%10th90th$56Professionalmedian $58 · 10th–90th $58$580%50%100%$58$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$32.36 / $32.36 / $45.71
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$56.23 / $66.07 / $104.71
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$100.00 / $138.04 / $138.04
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54