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Wisconsin rates for HCPCS 53400

Urethroplasty 1st Stg Fistula/Diverticulum/Strix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$807.28 / $1,643.76 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,720.00 / $15,579.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,061.76 / $2,409.33 / $3,886.17
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$807.28 / $1,065.23 / $2,764.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$807.28 / $2,764.41 / $12,631.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$803.62 / $1,065.23 / $2,764.41
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,567.15 / $2,419.92 / $3,239.64
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,302.50 / $14,302.50 / $14,302.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,073.00 / $9,837.00 / $12,062.00