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Wisconsin rates for HCPCS 01742

Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $47.86 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $47.86 / $537.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $478.63 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $338.84 / $575.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $69.18 / $107.15
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $57.54 / $95.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $69.18 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $70.79 / $478.63
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $389.05 / $602.56
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $630.96 / $1,348.96
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $831.76 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $60.26 / $93.33