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Wisconsin rates for HCPCS 86653

Antibody; encephalitis, St. Louis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $29.51 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.96 / $15.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $35.48 / $36.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $6.46 / $45.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $10.47 / $10.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $41.69 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $19.05 / $40.74
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $27.54 / $46.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $12.30 / $120.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $7.94 / $20.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $32.36 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $33.88 / $64.57
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $120.23
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $8.71 / $12.88
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $28.18
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $27.54 / $72.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $11.75 / $15.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $7.94 / $25.70