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Wisconsin rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Facilitymedian $245 · 10th–90th $115–$4680%20%10th90th$245Professionalmedian $257 · 10th–90th $245–$6170%50%10th90th$257$2.0$10.0$50.0$200.0$1.0K

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
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $251.19 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $263.03 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $398.11 / $549.54
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $245.47 / $346.74
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $194.98 / $234.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $263.03 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $537.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $724.44 / $1,071.52
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $269.15 / $912.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $323.59 / $1,380.38
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $1,122.02 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $346.74