go back

Wisconsin rates for HCPCS 64809

Sympathectomy Thoracolumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.39 / $2,106.46 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.39 / $1,105.01 / $3,978.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $10,800.00 / $19,822.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.59 / $1,995.93 / $5,563.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,648.39 / $3,094.86 / $4,747.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,564.46 / $3,959.04 / $4,498.91
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.39 / $1,316.55 / $2,106.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.39 / $1,669.92 / $5,887.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$969.65 / $1,951.66 / $9,251.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.28 / $690.66 / $2,224.17
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.39 / $1,235.33 / $2,106.46
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,180.10 / $2,656.37 / $3,965.43
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,253.43 / $20,253.43 / $20,253.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,989.00 / $4,886.70 / $9,251.14
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,534.05 / $3,534.05 / $3,534.05
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,827.56 / $4,819.39 / $5,928.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.00 / $4,810.00 / $19,003.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.86 / $1,794.59 / $4,283.18