go back

Wisconsin rates for HCPCS 54130

Amputation Penis Radw/Bi Inguinofemoral Lmphade

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.70 / $2,437.36 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,199.23 / $1,277.70 / $3,970.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,979.00 / $13,152.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,171.91 / $3,101.04 / $6,744.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,057.50 / $3,572.93 / $5,763.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,614.08 / $3,701.82 / $4,892.02
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.59 / $1,640.67 / $2,590.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.70 / $2,590.50 / $7,700.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,385.32 / $2,860.53 / $6,299.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $977.89 / $2,547.99
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.70 / $1,694.43 / $2,590.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,323.10 / $3,587.22 / $4,225.54
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,712.01 / $9,712.01 / $9,712.01
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,649.66 / $5,819.25 / $10,316.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,242.97 / $3,242.97 / $3,242.97
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,410.13 / $5,731.17 / $5,731.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,316.80 / $19,003.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.02 / $3,416.59 / $5,524.88