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Wisconsin rates for HCPCS 25115

Rad Exc Bursa Synva Wrst/F/Arm Tdn Shths Flxrs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.79 / $1,571.11 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,740.00 / $4,780.00 / $7,344.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,942.50 / $1,942.50 / $1,942.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,983.37 / $2,317.71 / $3,555.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.79 / $1,067.59 / $1,745.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.79 / $1,514.68 / $7,891.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.79 / $1,067.59 / $1,745.68
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.10 / $1,848.53 / $2,759.49
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,722.47 / $1,722.47 / $4,754.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,103.00 / $6,477.00 / $8,384.00