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Wisconsin rates for HCPCS 11004

Dbrdmt Skn Sbq T/M/F Necro Infctj Xtrnl Gent&Per

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.50 / $1,117.73 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,192.06 / $2,856.00 / $4,612.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,394.93 / $1,630.09 / $2,500.60
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.77 / $768.38 / $1,640.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.83 / $1,612.56 / $6,283.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.77 / $768.38 / $1,640.55
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,055.34 / $1,353.14 / $1,920.30
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.14 / $5,205.20 / $5,205.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,429.00 / $6,163.00 / $19,003.00