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Wisconsin rates for HCPCS 21390

Optx Orb Floor Blwt Fx Pri/Bital Appr W/Allplstc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.48 / $1,649.74 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,948.00 / $15,579.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,995.29 / $5,995.29 / $5,995.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,105.02 / $2,459.88 / $3,773.52
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.48 / $1,099.83 / $1,833.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.48 / $1,627.44 / $13,250.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.48 / $1,099.83 / $1,833.05
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.45 / $1,911.10 / $2,852.89
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,994.41 / $5,994.41 / $16,547.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,266.00 / $11,608.00 / $13,980.00