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Wisconsin rates for HCPCS 77421

Strsc X-Ray Gdn Loclzj Target Vol Dlvr Radj Ther

Facilitymedian $219 · 10th–90th $186–$3720%20%10th90th$219Professionalmedian $135 · 10th–90th $110–$5130%20%10th90th$135$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
$186.21 / $218.78 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $131.83 / $165.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
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
$165.96 / $165.96 / $512.86
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $512.86 / $512.86