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Wisconsin rates for HCPCS 77404

Radj Dlvr 1 Area 1/Prll Opsd Ports Smpl 11-19Mev

Facilitymedian $427 · 10th–90th $355–$6610%20%10th90th$427Professionalmedian $251 · 10th–90th $204–$5250%20%10th90th$251$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
$354.81 / $407.38 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $524.81 / $524.81
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
$302.00 / $426.58 / $426.58
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $524.81 / $524.81