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Wisconsin rates for HCPCS 0674T

Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,461.00 / $6,461.00 / $17,823.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.49 / $720.49 / $720.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,078.00 / $20,369.00 / $39,888.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,078.00 / $19,708.00 / $24,111.00