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Wisconsin rates for HCPCS G2004

Comprehensive (60 minutes) in-home visit for a new patient postdischarge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than nine times.)

Facilitymedian $162 · 10th–90th $138–$4900%10%20%10th90th$162Professionalmedian $170 · 10th–90th $135–$3890%10%20%10th90th$170$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $147.91 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $489.78 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $245.47 / $302.00
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $151.36 / $223.87
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $295.12 / $478.63
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $323.59 / $1,096.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $165.96 / $436.52
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $263.03 / $524.81
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $1,096.48
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $891.25 / $1,096.48
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $288.40 / $478.63