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Wisconsin rates for HCPCS 61703

Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,169.04 / $2,617.58 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,169.04 / $1,209.76 / $4,415.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,499.00 / $16,401.00 / $25,162.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,223.00 / $3,454.89 / $9,329.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,286.38 / $3,840.40 / $6,194.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,402.27 / $4,919.43 / $5,590.28
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,169.04 / $1,494.65 / $2,501.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,279.71 / $2,501.25 / $7,700.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.93 / $3,401.18 / $9,411.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.33 / $1,116.79 / $2,925.71
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,169.04 / $1,494.65 / $2,501.25
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,717.00 / $4,180.00 / $5,519.62
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,215.04 / $25,215.04 / $25,215.04
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,471.48 / $6,098.90 / $9,687.12
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,394.85 / $4,394.85 / $4,394.85
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,177.41 / $7,366.37 / $7,366.37
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
$1,446.50 / $4,098.46 / $6,164.28