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Amantadine Hydrochloride, Oral

Wisconsin rates for HCPCS G9017

Amantadine hcl 100mg oral

Rates data updated July 2026.

Facilitymedian $6 · 10th–90th $3$1000%20%10th90th$6Professionalmedian $1 · 10th–90th $1$10%20%40%10th90th$1$2.0$5.0$10.0$20.0$50.0$100.0

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
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.69
Median
$3.16
Typical High
$5.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.26
Typical High
$1.45
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
$50.12
Typical High
$58.88
Quartz
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$100.00