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Wisconsin rates for HCPCS 57415

Removal Impacted Vag Fb Spx W/Anes Oth/Thn Local

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.54 / $358.02 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,740.00 / $4,780.00 / $7,344.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.57 / $537.04 / $866.24
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.03 / $197.82 / $673.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.50 / $673.74 / $8,384.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.03 / $197.82 / $673.74
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.85 / $497.68 / $625.44
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,496.40 / $9,496.40 / $9,496.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,918.00 / $6,754.00 / $8,384.00