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Wisconsin rates for HCPCS 67039

Vitrectomy Mchnl Pars Plna Focal Endolaser Pc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,433.29 / $3,514.08 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,948.00 / $15,579.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.54 / $2,954.80 / $4,765.99
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$922.32 / $1,417.96 / $1,948.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.59 / $5,266.00 / $14,978.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$922.32 / $1,402.13 / $3,197.13
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,703.40 / $2,248.48 / $3,356.55
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,879.05 / $11,879.05 / $11,879.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,301.00 / $11,608.00 / $13,980.00