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Wisconsin rates for HCPCS 80375

Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3

Facilitymedian $50 · 10th–90th $14–$1120%20%10th90th$50Professionalmedian $26 · 10th–90th $9–$780%20%10th90th$26$2.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $288.40 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $31.62 / $74.13
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $43.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $13.80 / $42.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $85.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $56.23 / $79.43
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $19.05 / $23.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $14.13 / $41.69