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Wisconsin rates for HCPCS 25605

Cltx Dstl Rdl Fx/Epiphysl Sep W/Manj When Perf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.40 / $1,071.22 / $5,109.51
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$379.73 / $803.42 / $1,521.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.30 / $649.12 / $2,520.00
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
$518.79 / $1,019.95 / $2,953.91
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
$1,450.80 / $1,695.38 / $2,600.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.56 / $1,545.39 / $2,509.03
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.45 / $647.45 / $1,190.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.13 / $805.65 / $3,026.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.22 / $1,192.29 / $4,098.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.84 / $310.76 / $1,015.11
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.45 / $646.19 / $1,190.25
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,097.84 / $1,344.65 / $1,980.44
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,722.47 / $1,722.47 / $2,458.40
Quartz
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$1,688.06 / $1,688.06 / $1,688.06
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.01 / $2,439.65 / $4,098.39
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.36 / $3,307.92 / $3,513.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,367.00 / $3,088.30 / $4,295.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.70 / $1,046.79 / $2,352.53