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Wisconsin rates for HCPCS 20924

Tendon Graft From A Distance

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.88 / $1,043.05 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,139.00 / $13,743.77 / $21,606.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,560.77 / $7,560.77 / $7,560.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,319.24 / $1,541.64 / $2,364.91
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.58 / $593.38 / $1,158.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.58 / $1,010.33 / $11,598.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.58 / $593.38 / $1,158.95
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,006.20 / $1,226.02 / $1,830.20
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,213.88 / $7,213.88 / $19,913.50
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,887.52 / $1,887.52 / $1,887.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,240.00 / $9,158.00 / $12,062.00