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Wisconsin rates for HCPCS 15770

Graft; derma-fat-fascia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $1,380.38 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $676.08 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $7,943.28 / $13,182.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,288.25 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $2,041.74 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,479.11 / $1,995.26
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $1,949.84 / $5,754.40
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,659.59 / $2,089.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,995.26 / $11,481.54
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,000.00 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,445.44 / $2,089.30
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $11,220.18 / $11,220.18
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$758.58 / $758.58 / $1,122.02
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,230.27 / $4,897.79
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,884.03 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,232.93 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $954.99 / $2,570.40