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Wisconsin rates for HCPCS 80177

Levetiracetam

Facilitymedian $105 · 10th–90th $18$2690%10%10th90th$105Professionalmedian $12 · 10th–90th $7$470%10%10th90th$12$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $120.23 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.96 / $38.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $35.48 / $36.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $52.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $13.80
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $13.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $41.69 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $41.69
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $28.84 / $104.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $15.85 / $138.04
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $10.96 / $29.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $32.36 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $15.85 / $20.42
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $21.88 / $37.15
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $33.88 / $46.77
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $63.10
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $8.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $28.18
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $44.67 / $72.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $11.75 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $10.72 / $29.51