go back

Wisconsin rates for HCPCS 19371

Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $4,073.80 / $10,000.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,317.64 / $13,182.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $3,388.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $4,466.84 / $8,912.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $6,606.93 / $12,302.69
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$6,456.54 / $6,456.54 / $6,456.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,659.59 / $2,290.87
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,888.44 / $8,709.64 / $8,709.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,232.93 / $13,182.57