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Unclassified Diagnostic Radiopharmaceutical

Wisconsin rates for HCPCS A4641

Radiopharmaceutical, diagnostic, not otherwise classified

Rates data updated July 2026.

Facilitymedian $117 · 10th–90th $107$4570%20%40%10th90th$117Professionalmedian $91 · 10th–90th $32$910%50%10th$91$20.0$50.0$100.0$200.0$500.0

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
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$158.49
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$117.49
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$117.49
Typical High
$457.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$54.95
Typical High
$85.11
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$117.49
Quartz
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
United
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$16.98
Typical High
$21.38