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Wisconsin rates for HCPCS 15758

Free fascial flap with microvascular anastomosis

Facilitymedian $7,586 · 10th–90th $2,630–$12,5890%10%10th90th$7,586Professionalmedian $4,571 · 10th–90th $3,311–$6,7610%20%10th90th$4,571$2.0K$5.0K$10.0K$20.0K

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
$1,862.09 / $4,570.88 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $7,943.28 / $13,489.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $6,760.83 / $10,715.19
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,365.16 / $7,244.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $5,495.41 / $8,317.64
Medica
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $6,456.54
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $5,754.40 / $7,762.47
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,570.88 / $6,760.83
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $14,125.38 / $14,125.38
Quartz
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $8,912.51
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $7,413.10 / $9,120.11