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Wisconsin rates for HCPCS 25101

Arthrt Wrst W/Jt Expl W/Wo Bx W/Wo Rmvl Loose/Fb

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.92 / $853.34 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $8,139.00 / $11,136.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,462.54 / $3,462.54 / $3,462.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,082.25 / $1,264.69 / $1,940.07
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.92 / $599.88 / $948.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.92 / $846.03 / $11,100.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.92 / $599.88 / $948.15
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.95 / $1,000.30 / $1,493.24
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,244.77 / $3,244.77 / $8,957.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,241.00 / $9,837.00 / $12,062.00