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Wisconsin rates for HCPCS C9064

Mitomycin pyelocalyceal instillation, 1 mg

Facilitymedian $646 · 10th–90th $355–$1,1480%10%10th90th$646Professionalmedian $302 · 10th–90th $269–$3390%20%40%10th90th$302$100.0$200.0$500.0$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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $645.65 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $338.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,380.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44