go back

Wisconsin rates for HCPCS 01922

Anes Non-Invasive Imaging/Radiation Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.00 / $48.00 / $888.00
Aetna
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$323.70 / $323.70 / $323.70
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$1,178.99 / $1,587.50 / $2,201.50
Aetna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$682.03 / $902.88 / $1,523.25
Aetna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$254.44 / $913.24 / $1,531.71
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$1,415.25 / $1,415.25 / $2,303.64
Cigna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$930.86 / $930.86 / $1,057.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.43 / $22.43 / $22.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.04 / $553.84 / $1,000.00