go back

Topical Gastrointestinal Hemostatic Agent

Wisconsin rates for HCPCS C1052

Hemostatic agent, gastrointestinal, topical

Rates data updated July 2026.

How much does Topical Gastrointestinal Hemostatic Agent cost?

$661

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $661 from a physician practice, and about $100 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$661$52.48 to $661
FacilityA hospital or hospital-owned outpatient department$100$100 to $6,310

How much rates vary

Facilitymedian $100 · 10th to 90th $65 to $6,310Professionalmedian $661 · 10th to 90th $52 to $661
$100$200$500$1K$2K$5Kfacility $100professional $661

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Medica
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$70.79
Quartz
Setting
Professional
Modifier
Global
Typical Low
$5,888.44
Median
$5,888.44
Typical High
$5,888.44
Quartz
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$100.00
Quartz
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67

Where Wisconsin sits

The same service costs 16.6 times more in West Virginia than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 36th of 51

$661

WV $741NY $44.67

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.