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Wisconsin rates for HCPCS 49013

Preperitoneal Pel Pack F/Hemrrg Assoc Pel Trma

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$472.97 / $877.73 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,093.96 / $1,278.38 / $2,061.98
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.11 / $499.33 / $838.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.11 / $2,803.00 / $7,868.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.11 / $499.33 / $838.72
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$585.39 / $1,078.70 / $1,610.29
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,635.24 / $3,635.24 / $3,635.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,316.80 / $19,003.00