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Wisconsin rates for HCPCS 99475

Initial Ped Critical Care 2 Thru 5 Years

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$476.89 / $1,021.54 / $1,425.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,439.99 / $1,682.74 / $2,581.37
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.43 / $565.34 / $1,117.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.43 / $574.78 / $1,117.16
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.43 / $565.34 / $1,117.16
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.85 / $1,308.61 / $1,824.90
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.70 / $635.70 / $2,511.42