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Wisconsin rates for HCPCS 91110

Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report

Facilitymedian $347 · 10th–90th $120$7940%10%20%10th90th$347Professionalmedian $813 · 10th–90th $135$2,2390%10%10th90th$813$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Facility
Modifier
26
Typical Low / Median / Typical High
$120.23 / $120.23 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,230.27 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $199.53 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$630.96 / $977.24 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
53
Typical Low / Median / Typical High
$426.58 / $1,698.24 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$602.56 / $776.25 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,202.26 / $2,818.38
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$123.03 / $181.97 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$660.69 / $1,047.13 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$295.12 / $346.74 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,905.46 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$144.54 / $288.40 / $426.58
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$758.58 / $1,621.81 / $2,344.23
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,548.82 / $2,089.30
DeanCare
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$204.17 / $245.47 / $331.13
DeanCare
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$1,096.48 / $1,288.25 / $1,778.28
Medica
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Medica
Facility/Professional
Facility
Modifier
53
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,659.59 / $5,370.32
Medica
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$154.88 / $295.12 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$741.31 / $1,412.54 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,000.00
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,819.70 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$169.82 / $302.00 / $457.09
Network Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$891.25 / $1,621.81 / $1,949.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,905.46 / $2,630.27
Quartz
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$263.03 / $794.33 / $794.33
Quartz
Facility/Professional
Facility
Modifier
53
Typical Low / Median / Typical High
$323.59 / $1,000.00 / $1,000.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $4,168.69 / $5,495.41
Quartz
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$151.36 / $776.25 / $1,047.13
Quartz
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$758.58 / $3,548.13 / $4,570.88
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,884.03 / $4,265.80
Security Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$288.40 / $426.58 / $524.81
Security Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$977.24 / $1,905.46 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,445.44 / $2,884.03
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$131.83 / $257.04 / $446.68
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$741.31 / $1,174.90 / $2,454.71