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Wisconsin rates for HCPCS 22319

Optx&/Rdctj Odntd Fx&/Dislc Ant W/Int Fixj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,667.70 / $3,516.07 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,639.71 / $1,817.81 / $7,830.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,169.00 / $7,532.89 / $17,296.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,646.24 / $3,848.54 / $10,510.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,415.49 / $5,159.85 / $7,915.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,490.73 / $7,069.59 / $8,062.04
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,667.70 / $2,500.32 / $3,906.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,667.70 / $3,433.87 / $14,246.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,923.35 / $3,458.49 / $18,574.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.91 / $1,064.44 / $3,380.07
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,667.70 / $2,479.25 / $3,906.75
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,650.40 / $4,447.87 / $6,639.80
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,305.92 / $23,305.92 / $23,305.92
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,193.51 / $8,191.30 / $18,574.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,518.30 / $5,518.30 / $5,518.30
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,091.59 / $10,404.51 / $10,862.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,154.00 / $11,891.00 / $15,090.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,900.12 / $3,374.22 / $7,454.08