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Wisconsin rates for HCPCS 21196

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,422.05 / $4,121.50 / $17,831.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,298.96 / $1,422.05 / $5,583.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,948.00 / $15,579.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,413.40 / $3,281.65 / $8,826.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,753.16 / $4,385.87 / $6,728.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,040.13 / $5,746.21 / $6,529.79
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,405.52 / $1,978.76 / $3,284.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,405.52 / $2,934.70 / $13,442.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,641.60 / $3,350.78 / $15,789.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.60 / $831.84 / $2,698.96
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,405.52 / $1,970.76 / $3,284.60
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,788.50 / $3,397.68 / $5,072.07
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,377.52 / $13,377.52 / $13,377.52
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,688.41 / $6,929.80 / $15,789.51
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,734.37 / $4,734.37 / $4,734.37
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,851.18 / $7,285.24 / $9,144.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,266.00 / $11,608.00 / $13,980.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,551.39 / $3,007.51 / $6,306.12