go back

Wisconsin rates for HCPCS 68850

Injection Contrast Medium Dacryocystograpy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.58 / $120.26 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.15 / $77.58 / $186.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,139.00 / $1,183.00 / $1,530.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.21 / $117.84 / $350.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.09 / $180.07 / $239.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.59 / $163.02 / $224.49
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.08 / $86.02 / $280.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.08 / $102.82 / $1,449.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.56 / $251.37 / $3,468.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $70.00 / $163.35
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.08 / $88.26 / $280.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.31 / $154.00 / $196.74
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.15 / $817.17 / $1,300.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.63 / $279.18 / $3,468.63
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.38 / $243.38 / $280.35
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.93 / $497.93 / $566.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,008.00 / $1,533.00 / $2,202.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.03 / $186.59 / $427.21