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Wisconsin rates for HCPCS 20902

Bone graft, any donor area; major or large

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $1,659.59 / $17,782.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,715.19 / $15,135.61 / $26,302.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $812.83 / $1,348.96
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $691.83 / $6,456.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $724.44 / $11,481.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $575.44 / $870.96
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $13,489.63 / $19,952.62
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,348.96 / $1,348.96 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,232.93 / $14,454.40