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Wisconsin rates for HCPCS 64809

Sympathectomy, thoracolumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $2,089.30 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,096.48 / $2,454.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,964.78 / $20,892.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,949.84 / $4,786.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $3,090.30 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $4,073.80 / $4,570.88
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,819.70 / $10,000.00
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,344.23 / $3,019.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,819.70 / $7,585.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,698.24 / $9,332.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,630.27 / $3,981.07
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $19,952.62 / $19,952.62
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $4,897.79 / $9,332.54
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $5,888.44 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,165.95 / $19,498.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,479.11 / $4,168.69