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Wisconsin rates for HCPCS 0100T

Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy

Facilitymedian $17,378 · 10th–90th $9,772–$29,5120%20%10th90th$17,378Professionalmedian $1,862 · 10th–90th $1,259–$5,1290%20%10th90th$1,862$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$1,148.15 / $1,148.15 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,659.59 / $2,290.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $17,378.01 / $30,902.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,570.40 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,715.35 / $3,715.35
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,949.84 / $3,890.45
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $13,803.84 / $28,840.32
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,548.13 / $13,803.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $20,417.38 / $51,286.14
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,890.45 / $5,623.41
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,489.63 / $23,988.33 / $23,988.33
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $12,882.50 / $12,882.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $21,877.62 / $33,113.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,019.95 / $7,943.28