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Wisconsin rates for HCPCS 39540

Repair, diaphragmatic hernia (other than neonatal), traumatic; acute

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,698.24 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $12,882.50 / $22,387.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,511.89 / $3,981.07
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $6,918.31 / $13,489.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,691.53 / $7,943.28
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $2,089.30 / $3,548.13
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $7,762.47 / $7,762.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,165.95 / $19,498.45