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Wisconsin rates for HCPCS 63064

Costovertebral Dcmprn Spinal Cord Thoracic 1 Seg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,540.98 / $3,421.40 / $14,482.00
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
$4,307.35 / $5,033.47 / $7,721.49
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,540.98 / $2,311.46 / $3,713.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,540.98 / $3,060.29 / $15,090.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,540.98 / $2,296.06 / $3,713.22
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,493.10 / $4,256.21 / $6,353.68
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,572.22 / $22,572.22 / $22,572.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,627.00 / $12,373.00 / $15,090.00