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Wisconsin rates for HCPCS 0657T

Anterior lumbar or thoracolumbar vertebral body tethering; 8 or more vertebral segments

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,187.76 / $2,754.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $16,218.10 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $4,897.79 / $12,022.64
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $2,137.96 / $3,311.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,630.27 / $7,762.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,981.07 / $16,982.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $5,495.41 / $7,585.78
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $5,754.40 / $41,686.94
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,332.54 / $16,595.87 / $16,595.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,606.93 / $19,498.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,467.37 / $9,120.11