go back

Wisconsin rates for HCPCS 90958

End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$536.07 / $1,853.46 / $1,853.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.82 / $502.71 / $643.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.23 / $641.37 / $1,622.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,308.43 / $1,529.00 / $2,345.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.52 / $1,124.66 / $1,662.62
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.10 / $536.07 / $981.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.66 / $536.07 / $1,013.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.23 / $742.78 / $3,624.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.24 / $486.13 / $1,010.24
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.10 / $533.03 / $993.75
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.13 / $1,149.24 / $1,639.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$569.26 / $1,003.00 / $2,255.57
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.97 / $2,147.65 / $3,624.69
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.83 / $841.89 / $1,745.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.53 / $660.92 / $1,580.94