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Wisconsin rates for HCPCS 21049

Exc B9 Tum/Cst Maxl Xtr-Oral Osteot&Prtl Maxlc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,094.72 / $1,143.72 / $4,888.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,165.10 / $2,613.84 / $7,378.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,771.97 / $4,604.18 / $5,232.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,324.08 / $2,361.39 / $9,976.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.64 / $665.14 / $2,105.60
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,258.75 / $2,752.20 / $4,108.49
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,154.10 / $5,819.60 / $9,976.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,543.63 / $6,002.48 / $7,327.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.18 / $2,291.52 / $5,295.84