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Wisconsin rates for HCPCS 75809

Shuntogram Indwelling Nonvascular Shunt Rs&I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$34.33 / $47.48 / $47.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.43 / $98.79 / $165.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.23 / $188.39 / $505.72
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$58.57 / $68.45 / $90.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $286.64 / $325.74
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$102.96 / $102.96 / $102.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.50 / $212.01 / $758.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.69 / $69.31 / $148.66
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.81 / $191.68 / $346.61
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $102.96 / $102.96
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.72 / $439.90 / $758.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.91 / $510.78 / $510.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.75 / $177.14 / $385.57