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Wisconsin rates for HCPCS 84620

Xylose absorption test, blood and/or urine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $19.37 / $28.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.59 / $12.26 / $46.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.76 / $33.57 / $35.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.85 / $5.85 / $53.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.65 / $32.15 / $33.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.14 / $41.07 / $63.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.87 / $34.76 / $39.50
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.55 / $10.55 / $15.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.55 / $11.40 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.49 / $12.91 / $34.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $23.22 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.55 / $10.55 / $15.49
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.20 / $31.68 / $48.73
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.82 / $25.82 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.84 / $7.84 / $11.50
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.19 / $12.19 / $27.49
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.19 / $13.17 / $70.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.91 / $12.91 / $12.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.95 / $10.33 / $34.76