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Wisconsin rates for HCPCS 0215T

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $95.50 / $112.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,584.89 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $134.90 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $190.55 / $190.55
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $97.72 / $194.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $194.98 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $177.83 / $776.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $251.19 / $346.74
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $263.03 / $616.60
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $467.74 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $1,949.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $154.88 / $446.68