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Wisconsin rates for HCPCS 21048

Exc Benign Tumor/Cyst Maxl Intra-Oral Osteot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.47 / $1,005.19 / $3,927.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.57 / $2,279.51 / $6,379.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,525.39 / $4,016.84 / $4,564.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,161.94 / $2,236.50 / $9,057.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.66 / $603.01 / $1,915.55
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.05 / $2,389.46 / $3,567.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,879.30 / $5,203.35 / $9,057.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,187.33 / $5,627.82 / $6,392.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,134.98 / $2,236.50 / $4,735.05