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Wisconsin rates for HCPCS 65103

Enucleation Eye Implt Musc X Attached Implt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,331.47 / $3,211.65 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,169.00 / $8,408.00 / $12,444.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,360.03 / $2,757.89 / $4,448.37
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.91 / $1,073.52 / $1,797.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.24 / $4,240.00 / $11,598.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.91 / $1,073.52 / $1,911.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.40 / $2,054.44 / $2,916.17
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,001.70 / $9,001.70 / $9,001.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,241.00 / $9,837.00 / $12,062.00