go back

Wisconsin rates for HCPCS 15840

Graft Facial Nerve Paralysis Free Fascial Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$846.25 / $2,060.17 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.36 / $3,063.26 / $4,699.13
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.63 / $1,356.78 / $2,873.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$985.79 / $2,746.89 / $11,598.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.63 / $1,356.78 / $2,873.73
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,896.64 / $2,431.81 / $3,451.09
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,529.08 / $11,102.00 / $11,102.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,241.00 / $9,837.00 / $12,062.00