go back

Wisconsin rates for HCPCS 75801

Lymphangiography, extremity only, unilateral, radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$60.26 / $60.26 / $85.11
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$107.15 / $123.03 / $199.53
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$194.98 / $194.98 / $194.98
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $263.03 / $263.03