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Wisconsin rates for HCPCS 84081

Phosphatidylglycerol

Facilitymedian $35 · 10th–90th $15$1000%10%20%10th90th$35Professionalmedian $15 · 10th–90th $8$650%10%10th90th$15$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
$19.05 / $37.15 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.14 / $19.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $44.67 / $45.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $66.07
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $52.48 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $51.29
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $36.31 / $131.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $15.49 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $13.80 / $37.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $32.36 / $64.57
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $46.77
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $26.92 / $46.77
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $41.69 / $186.21
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $10.96 / $16.22
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $35.48
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $102.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $14.79 / $19.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $13.49 / $37.15