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Wisconsin rates for HCPCS 77750

Infusion or instillation of radioelement solution (includes 3-month follow-up care)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$398.11 / $398.11 / $562.34
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$691.83 / $812.83 / $1,288.25
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$616.60 / $1,621.81 / $1,621.81