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Wisconsin rates for HCPCS 42815

Exc Branchial Cleft Cyst Below Subq Tiss&/Phrynx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.95 / $1,971.96 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $10,038.00 / $15,579.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,415.66 / $1,654.31 / $2,537.75
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.50 / $714.81 / $1,404.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$518.69 / $810.39 / $12,855.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.50 / $707.80 / $1,404.80
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.40 / $1,303.53 / $2,252.90
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$608.17 / $16,547.20 / $16,547.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,301.00 / $11,799.00 / $13,980.00