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Wisconsin rates for HCPCS 15734

Musc Myocutaneous/Fasciocutaneous Flap Trunk

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,224.67 / $3,004.16 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,140.02 / $1,443.92 / $9,553.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,376.04 / $3,180.94 / $6,529.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,340.10 / $1,602.22 / $1,802.49
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,335.18 / $1,468.70 / $1,919.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,780.20 / $4,417.46 / $6,776.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,399.62 / $2,670.36 / $4,240.26
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,392.26 / $2,006.66 / $4,331.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,432.86 / $4,020.30 / $11,598.00
Medica
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$6,576.94 / $6,576.94 / $6,576.94
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,052.31 / $1,052.31 / $1,052.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,440.21 / $2,508.96 / $6,940.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.82 / $877.07 / $2,719.07
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,392.26 / $2,006.66 / $4,331.55
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,829.05 / $3,627.31 / $5,147.67
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,529.08 / $11,102.00 / $11,102.00
Quartz
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$4,705.68 / $6,576.94 / $6,576.94
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$752.91 / $1,052.31 / $1,052.31
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,690.11 / $6,133.46 / $12,056.47
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,611.17 / $3,403.78 / $6,204.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,073.00 / $9,837.00 / $12,062.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,427.40 / $2,352.28 / $5,702.51