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Wisconsin rates for HCPCS J2760

Injection, phentolamine mesylate, up to 5 mg

Facilitymedian $490 · 10th–90th $324–$1,2590%20%10th90th$490Professionalmedian $417 · 10th–90th $257–$7590%20%40%10th90th$417$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$436.52 / $630.96 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $707.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $776.25 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $537.03 / $776.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $436.52 / $954.99
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $870.96 / $870.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $436.52 / $954.99
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $416.87
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $1,288.25
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $2,137.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $346.74 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $446.68 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $575.44