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Wisconsin rates for HCPCS 58240

Pel Exntj Gynecologic Mal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,135.00 / $5,925.10 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,571.07 / $3,135.00 / $9,534.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $11,015.00 / $15,810.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,787.94 / $7,563.19 / $15,968.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,453.16 / $8,709.61 / $14,048.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,345.07 / $8,523.67 / $11,914.37
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,896.72 / $3,536.91 / $5,661.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,571.07 / $3,667.95 / $7,700.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,241.07 / $7,024.62 / $13,741.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.34 / $1,816.98 / $5,825.95
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,918.66 / $3,536.91 / $5,661.77
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,746.00 / $8,840.00 / $10,451.53
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,704.04 / $30,704.04 / $30,704.04
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,444.97 / $13,929.20 / $21,615.68
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,180.86 / $7,180.86 / $7,180.86
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,112.76 / $15,571.11 / $15,571.11
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
$3,238.08 / $8,466.69 / $12,208.94