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Wisconsin rates for HCPCS 42975

Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.95 / $4,073.80 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $131.83 / $446.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,570.88 / $7,079.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $181.97 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $295.12 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $354.81 / $407.38
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $2,630.27 / $5,128.61
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $239.88 / $281.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $1,445.44 / $3,235.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $213.80 / $630.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $218.78 / $302.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $4,466.84
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $398.11 / $707.95
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $489.78 / $630.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $177.83 / $512.86