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Wisconsin rates for HCPCS 76642

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $527.04 / $786.72
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$48.85 / $67.86 / $68.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.01 / $191.06 / $661.71
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.72 / $114.40 / $413.10
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$111.81 / $601.50 / $1,730.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.26 / $79.01 / $314.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.49 / $127.86 / $463.07
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.52 / $51.18 / $176.62
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$123.73 / $229.35 / $694.60
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$50.97 / $79.01 / $287.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.77 / $61.50 / $107.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.59 / $60.68 / $105.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.69 / $269.58 / $413.54
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$84.71 / $98.98 / $151.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.24 / $298.68 / $339.41
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.02 / $113.06 / $128.47
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$65.23 / $185.63 / $210.94
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.61 / $111.92 / $175.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.61 / $166.22 / $514.16
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$146.86 / $146.86 / $294.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.99 / $180.75 / $546.22
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.29 / $80.62 / $203.94
Medica
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$381.38 / $556.30 / $800.47
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$55.80 / $105.55 / $342.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.69 / $85.31 / $191.69
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.61 / $111.92 / $175.80
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.52 / $200.36 / $361.16
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.90 / $514.16 / $514.16
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$76.80 / $146.86 / $146.86
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.81 / $407.83 / $546.22
Quartz
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.62 / $167.25 / $203.94
Quartz
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.19 / $257.45 / $342.28
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.57 / $532.25 / $532.25
Security Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.64 / $98.40 / $124.51
Security Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$130.93 / $154.03 / $194.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.04 / $104.04 / $104.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.62 / $166.99 / $344.01
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.32 / $66.48 / $146.60
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.49 / $104.52 / $225.65