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Wisconsin rates for HCPCS 41150

Glssc Composit W/Rescj Floor & Mandibular Rescj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,426.03 / $4,456.89 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $10,908.00 / $18,360.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,700.49 / $6,661.47 / $10,218.86
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,063.98 / $2,535.48 / $4,258.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,043.75 / $2,803.00 / $5,728.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,062.13 / $2,516.46 / $4,258.81
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,930.00 / $5,241.31 / $9,076.44
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,450.09 / $20,467.28 / $20,467.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $6,032.00 / $19,003.00