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Wisconsin rates for HCPCS 49904

Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)

Facilitymedian $7,586 · 10th–90th $1,778–$14,4540%10%10th90th$7,586Professionalmedian $3,020 · 10th–90th $1,660–$4,8980%10%20%10th90th$3,020$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,754.23 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,317.64 / $13,803.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,073.80 / $6,456.54
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,778.28 / $8,912.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,778.28 / $7,585.78
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,884.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,019.95 / $4,677.35
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $21,877.62 / $21,877.62
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $6,760.83 / $19,498.45