go back

Wisconsin rates for HCPCS 67108

Rpr Retinal Dtchmnt W/Vitrectomy Any Meth

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,774.90 / $11,139.00 / $16,666.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.67 / $1,604.90 / $5,272.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,948.00 / $15,579.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,175.38 / $2,291.64 / $6,397.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,123.28 / $3,649.80 / $5,887.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,423.81 / $2,859.45 / $5,755.21
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,145.17 / $1,774.90 / $2,409.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,302.60 / $7,217.00 / $14,978.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.49 / $2,560.39 / $10,464.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.96 / $667.40 / $1,963.05
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,145.17 / $1,736.82 / $4,028.17
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,110.80 / $2,786.26 / $4,159.33
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,879.05 / $11,879.05 / $11,879.05
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$1,125.97 / $1,125.97 / $1,125.97
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,955.27 / $6,338.27 / $10,464.70
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,423.56 / $8,566.64 / $11,487.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,301.00 / $11,608.00 / $13,980.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,344.59 / $2,346.86 / $5,096.97