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Wisconsin rates for HCPCS 61650

Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $1,122.02 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $14,125.38 / $26,915.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,621.81 / $2,570.40
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $7,244.36 / $14,454.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $2,818.38 / $9,549.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,318.26 / $2,238.72
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $7,079.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,165.95 / $19,498.45