go back

Wisconsin rates for HCPCS 39501

Repair Laceration Diaphragm Any Approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.59 / $1,678.30 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,084.00 / $12,066.00 / $19,370.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,110.42 / $2,466.19 / $3,977.89
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.59 / $898.08 / $1,805.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$770.56 / $1,963.50 / $7,700.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.59 / $954.76 / $1,805.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,665.30 / $2,562.00 / $3,548.26
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,787.84 / $12,787.84 / $12,787.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,316.80 / $19,003.00