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Wisconsin rates for HCPCS 21295

Reduction Masseter Muscle & Bone Extraoral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.50 / $414.56 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.50 / $195.50 / $869.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,183.00 / $3,483.00 / $5,962.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.22 / $451.16 / $1,132.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,554.79 / $1,554.79 / $1,554.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$533.46 / $623.39 / $956.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.10 / $806.01 / $915.93
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.77 / $255.27 / $460.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.77 / $396.14 / $5,261.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.52 / $386.87 / $8,054.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.95 / $148.14 / $395.88
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.77 / $255.11 / $460.63
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.25 / $479.16 / $715.29
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.75 / $1,350.75 / $3,728.65
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.10 / $1,493.25 / $8,054.09
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.96 / $636.96 / $636.96
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.51 / $975.49 / $1,282.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,723.00 / $3,912.00 / $5,865.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.52 / $379.06 / $828.05