go back

Phenothiazine Level Test

Wisconsin rates for HCPCS 84022

Measures how much phenothiazine medicine is present in a sample. Phenothiazines are an older family of drugs used for psychosis, severe nausea and agitation, and the result helps a prescriber judge whether the amount in the body is about right or too high.

Rates data updated July 2026.

How much does Phenothiazine Level Test cost?

$27.54

Typical facility fee. In Wisconsin, July 2026.

Insurers have agreed to pay about $27.54 for this service. Most negotiated rates run $15.14 to $60.26.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $19 · 10th to 90th $14 to $91Professionalmedian $30 · 10th to 90th $25 to $36
$20$50$100facility $19professional $30

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$61.66
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$30.20
Typical High
$36.31
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$19.50
Medica
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$19.50
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$19.50
Quartz
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$100.00

Where Wisconsin sits

The same service costs 7.2 times more in Massachusetts than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 13th of 50

$27.54

MA $100KS $13.80

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.