go back

Wisconsin rates for HCPCS 42280

Maxillary impression for palatal prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $223.87 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $169.82 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,090.30 / $5,754.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $269.15 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $562.34 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $281.84 / $741.31
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $173.78 / $2,238.72
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $316.23 / $489.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $181.97 / $1,202.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $398.11 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $144.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $331.13 / $602.56
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $1,288.25 / $1,288.25
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $389.05 / $1,288.25
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $660.69
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $588.84 / $891.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $1,949.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $190.55 / $512.86