go back

Wisconsin rates for HCPCS 49255

Omntc Epiploectomy Rescj Omentum Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$849.62 / $2,831.70 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,979.00 / $13,297.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,998.68 / $2,335.62 / $3,582.90
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$763.04 / $973.45 / $1,694.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.16 / $1,059.95 / $7,318.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$763.04 / $969.05 / $1,679.68
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,442.40 / $1,923.68 / $3,212.05
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.20 / $7,381.44 / $7,381.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,918.00 / $7,280.00 / $8,384.00