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Wisconsin rates for HCPCS J3355

Injection, urofollitropin, 75 IU

Facilitymedian $120 · 10th–90th $59–$2290%10%20%10th90th$120Professionalmedian $126 · 10th–90th $68–$1620%20%40%10th90th$126$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
$85.11 / $158.49 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $87.10 / $117.49
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $81.28 / $151.36
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $81.28 / $151.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $162.18
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89