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Wisconsin rates for HCPCS 20930

Allograft For Spine Surgery Only Morselized

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.19 / $1,894.00 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.19 / $152.62 / $582.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,749.00 / $5,749.00 / $6,159.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $224.38 / $693.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.36 / $132.43 / $166.91
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.72 / $109.96 / $150.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$299.17 / $349.61 / $536.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.46 / $452.09 / $568.38
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.19 / $163.83 / $247.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.94 / $231.88 / $1,789.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.13 / $232.96 / $1,634.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.19 / $160.19 / $247.94
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.93 / $280.37 / $402.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.00 / $1,300.00 / $1,300.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.62 / $562.29 / $1,634.59
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.48 / $397.16 / $577.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,008.00 / $1,370.00 / $2,202.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.60 / $246.29 / $539.62