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Wisconsin rates for HCPCS 80158

Cyclosporine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.66 / $24.90 / $58.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.51 / $16.97 / $24.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.81 / $46.93 / $49.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $74.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.92 / $49.03 / $50.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.05 / $18.05 / $18.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.56 / $57.92 / $88.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.65 / $48.61 / $55.24
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $21.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.80 / $16.25 / $137.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.60 / $18.05 / $50.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.02 / $35.39 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $21.66
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.07 / $44.35 / $96.21
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.10 / $36.10 / $137.69
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.57 / $11.92 / $17.77
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.44 / $38.44 / $59.02
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.02 / $77.44 / $98.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.43 / $15.14 / $50.00