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Wisconsin rates for HCPCS 21154

Rcnstj Midface Lefort Iii W/O Lefort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.52 / $3,956.78 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.52 / $1,956.95 / $8,986.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $10,800.00 / $18,360.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,896.61 / $4,397.37 / $12,163.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,020.14 / $5,866.43 / $8,999.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,944.13 / $7,729.94 / $8,784.03
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.52 / $2,813.71 / $4,396.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.52 / $3,877.80 / $13,120.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,214.67 / $4,074.47 / $19,633.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.95 / $1,160.53 / $3,713.33
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.52 / $2,728.64 / $4,396.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,793.40 / $4,622.10 / $6,899.90
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,191.12 / $18,191.12 / $18,191.12
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,616.51 / $9,400.29 / $19,633.29
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,314.67 / $6,314.67 / $6,314.67
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,163.39 / $9,849.76 / $12,301.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,301.00 / $11,608.00 / $13,980.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,123.58 / $4,093.32 / $8,554.27