go back

Wisconsin rates for HCPCS 12011

Simple Repair F/E/E/N/L/M 2.5cm/<

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.62 / $394.25 / $756.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.93 / $124.94 / $592.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,139.00 / $2,479.00 / $4,441.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.64 / $175.47 / $419.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.93 / $49.54 / $71.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.56 / $111.72 / $139.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.57 / $345.39 / $529.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.22 / $145.07 / $326.13
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.57 / $130.00 / $305.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.69 / $207.00 / $1,449.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.70 / $214.00 / $499.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.91 / $95.42 / $218.92
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.57 / $130.00 / $305.85
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.95 / $196.61 / $364.57
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.24 / $137.97 / $384.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.57 / $265.20 / $918.11
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.70 / $227.79 / $477.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,034.00 / $1,423.00 / $2,202.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.44 / $169.40 / $415.31