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Wisconsin rates for HCPCS 77403

Radj Dlvr 1 Area 1/Prll Opsd Ports Smpl 6-10Mev

Facilitymedian $389 · 10th–90th $316$5890%20%10th90th$389Professionalmedian $229 · 10th–90th $182$4680%20%10th90th$229$100.0$200.0$500.0

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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $223.87 / $281.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $467.74 / $467.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $389.05
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $467.74 / $467.74