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Wisconsin rates for HCPCS 12017

Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.07 / $299.81 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.26 / $131.97 / $508.64
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
$144.50 / $310.35 / $654.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.06 / $435.95 / $668.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.38 / $308.24 / $425.30
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.25 / $227.02 / $451.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.28 / $442.05 / $1,789.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.15 / $299.54 / $792.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.09 / $171.21 / $386.45
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.25 / $227.02 / $451.14
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.08 / $368.09 / $522.38
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$824.68 / $2,000.00 / $2,000.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.25 / $615.20 / $2,380.89
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.93 / $270.93 / $270.93
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.89 / $521.47 / $622.37
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
$151.86 / $292.95 / $609.49