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Wisconsin rates for HCPCS 91111

Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$47.86 / $47.86 / $165.96
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$120.23 / $138.04 / $223.87
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$218.78 / $218.78 / $218.78
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$104.71 / $288.40 / $288.40