go back

Wisconsin rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Facilitymedian $1,622 · 10th–90th $126$4,6770%10%10th90th$1,622Professionalmedian $148 · 10th–90th $66$3890%5%10th90th$148$20.0$100.0$500.0$2.0K$10.0K

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
$67.61 / $346.74 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $128.82 / $309.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,090.30 / $5,754.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $213.80 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $407.38 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $186.21 / $389.05
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $208.93 / $3,388.44
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $239.88 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $251.19 / $616.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $229.09
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $891.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $295.12 / $380.19
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $257.04 / $537.03
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $1,621.81 / $1,621.81
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $190.55 / $1,096.48
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $245.47
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $302.00 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $169.82 / $416.87