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Wisconsin rates for HCPCS 64772

Transection/Avulsion Oth Spinal Nrv Xdrl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.09 / $1,559.50 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,740.00 / $4,780.00 / $7,344.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,447.20 / $1,691.17 / $2,594.29
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.90 / $712.06 / $1,142.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.09 / $921.76 / $7,791.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.90 / $712.06 / $1,142.78
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,105.65 / $1,347.19 / $2,011.09
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,900.50 / $1,900.50 / $5,246.20
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$497.27 / $497.27 / $497.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,918.00 / $6,477.00 / $8,384.00