go back

Wisconsin rates for HCPCS 61517

Impltj Brain Intracavitary Chemotherapy Agent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.70 / $161.78 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,740.00 / $4,338.00 / $6,049.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.85 / $235.88 / $380.46
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.70 / $110.52 / $156.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.09 / $1,716.00 / $7,700.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.70 / $110.52 / $156.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.60 / $264.00 / $353.06
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.00 / $1,300.00 / $1,300.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,316.80 / $19,003.00