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Wisconsin rates for HCPCS 0695T

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.03 / $93.03 / $93.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.03 / $150.05 / $243.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.22 / $331.60 / $1,047.47
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.03 / $173.72 / $311.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.44 / $185.31 / $311.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.97 / $316.43 / $892.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.03 / $173.72 / $311.26
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.87 / $372.31 / $519.20
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$714.54 / $714.54 / $714.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.14 / $1,169.68 / $1,169.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.97 / $466.35 / $725.83