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Wisconsin rates for HCPCS 28304

Osteotomy Tarsal Bones Oth/Thn Calcaneus/Talus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.48 / $1,274.83 / $3,119.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,878.00 / $14,586.00 / $21,869.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,560.77 / $7,560.77 / $7,560.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,188.82 / $2,557.81 / $3,923.75
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.66 / $903.72 / $1,692.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.83 / $1,004.82 / $12,741.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.66 / $903.72 / $1,692.18
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,362.27 / $1,922.85 / $2,802.63
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,897.76 / $2,897.76 / $7,213.88
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$284.14 / $284.14 / $284.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,154.00 / $11,891.00 / $15,090.00