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Wisconsin rates for HCPCS J0288

Injection, amphotericin B cholesteryl sulfate complex, 10 mg

Facilitymedian $71 · 10th–90th $19$1550%20%10th90th$71Professionalmedian $16 · 10th–90th $15$1230%20%40%10th90th$16$10.0$20.0$50.0$100.0$200.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $35.48 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $19.50 / $141.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $67.61 / $154.88
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $8.51 / $8.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $67.61 / $154.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $20.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $75.86 / $75.86
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $478.63 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85