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Wisconsin rates for HCPCS 12016

Simple Repair F/E/E/N/L/M 12.6cm-20.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.14 / $248.69 / $3,119.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,139.00 / $2,479.00 / $4,441.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$565.90 / $661.30 / $1,014.46
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.50 / $257.18 / $593.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.63 / $337.83 / $1,513.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.50 / $257.18 / $593.49
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.52 / $430.95 / $717.23
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.22 / $311.69 / $880.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,008.00 / $1,423.00 / $2,202.90