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Wisconsin rates for HCPCS 63042

Lamot Prtl Ffd Exc Disc Reexpl 1 Ntrspc Lumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,144.24 / $4,557.93 / $17,823.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,878.00 / $14,586.00 / $21,869.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,218.80 / $3,761.42 / $5,770.12
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,144.24 / $1,712.83 / $2,920.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,144.24 / $2,443.78 / $15,090.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,144.24 / $1,712.83 / $2,920.20
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,564.90 / $3,125.23 / $4,665.35
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,213.88 / $7,213.88 / $19,913.50
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,887.52 / $1,887.52 / $1,887.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,154.00 / $11,891.00 / $15,090.00