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Wisconsin rates for HCPCS A4641

Radiopharmaceutical, diagnostic, not otherwise classified

Facilitymedian $117 · 10th–90th $107–$4570%20%40%10th90th$117Professionalmedian $115 · 10th–90th $59–$1150%50%10th$115$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
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $158.49
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $117.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $117.49 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $21.38