go back

Wisconsin rates for HCPCS 35304

Teaec W/Graft Tibioperoneal Trunk Artery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,484.16 / $2,402.32 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $10,196.00 / $17,436.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,994.42 / $3,499.22 / $5,644.12
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.47 / $1,668.23 / $2,314.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,361.97 / $2,803.00 / $7,868.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.47 / $1,668.23 / $2,314.13
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,427.75 / $3,748.82 / $4,882.99
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,867.21 / $12,867.21 / $12,867.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,316.80 / $19,003.00