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Wisconsin rates for HCPCS 0450T

Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedure)

Facilitymedian $1,445 · 10th–90th $234–$5,6230%10%10th90th$1,445Professionalmedian $331 · 10th–90th $240–$1,0960%10%10th90th$331$50.0$200.0$1.0K$5.0K

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
$199.53 / $199.53 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $630.96 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $616.60 / $616.60
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $4,897.79 / $9,549.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,691.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $1,122.02 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $588.84 / $2,454.71
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
$831.76 / $933.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $776.25 / $1,096.48
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,995.26 / $1,995.26
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $2,398.83 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $512.86 / $1,288.25