go back

Wisconsin rates for HCPCS 14301

Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm

Facilitymedian $6,761 · 10th–90th $1,479$11,4820%5%10%10th90th$6,761Professionalmedian $1,318 · 10th–90th $339$4,0740%5%10th90th$1,318$50.0$200.0$1.0K$5.0K

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
$912.01 / $2,691.53 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,479.11 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$97.72 / $346.74 / $977.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,943.28 / $13,182.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $2,041.74 / $4,570.88
Anthem BCBS
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$147.91 / $288.40 / $645.65
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $977.24 / $1,071.52
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,071.52 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,311.31 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,737.80 / $2,884.03
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $2,344.23 / $6,165.95
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,290.87 / $3,162.28
DeanCare
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$218.78 / $323.59 / $446.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $2,454.71 / $10,964.78
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,905.46 / $6,456.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,630.27
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $8,511.38 / $9,120.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,511.89 / $3,801.89
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,511.89 / $3,715.35
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $11,220.18
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,122.02
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,380.38 / $7,762.47
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,995.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,630.78 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $10,232.93 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $1,778.28 / $6,456.54