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Wisconsin rates for HCPCS J1097

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

Facilitymedian $112 · 10th–90th $112$2750%20%40%90th$112Professionalmedian $117 · 10th–90th $112$1410%50%10th90th$117$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $114.82 / $141.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $213.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $275.42 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $128.82 / $147.91
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $141.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $181.97 / $269.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $154.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $524.81
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $162.18