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Wisconsin rates for HCPCS L3255

Nonstandard size or length

Facilitymedian $19 · 10th–90th $19–$490%50%10th90th$19Professionalmedian $19 · 10th–90th $19–$240%50%90th$19$20.0$50.0$100.0$200.0

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $24.55
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $35.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $48.98
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $54.95 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $17.38 / $24.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29