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Wisconsin rates for HCPCS 99476

Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $616.60 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,023.29 / $1,621.81
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $346.74 / $691.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $371.54 / $707.95
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $707.95 / $1,000.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $2,089.30