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Wisconsin rates for HCPCS 20103

Exploration of penetrating wound (separate procedure); extremity

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $1,148.15 / $7,079.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,090.30 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $1,737.80 / $2,754.23
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $691.83 / $8,709.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $707.95 / $3,630.78
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,096.48 / $1,949.84
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $2,754.23 / $3,981.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,884.03 / $5,011.87