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Wisconsin rates for HCPCS A4217

Sterile Water/Saline 500 Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $2.54 / $7.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $2.54 / $3.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.38 / $4.38 / $7.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.89 / $1.87 / $4.34
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.38 / $9.36 / $9.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.59 / $5.25 / $10.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.71 / $13.69 / $18.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $6.56 / $8.30
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $3.21 / $4.38
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $4.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $3.21 / $4.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.47 / $15.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $3.26 / $4.38
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $2.50 / $4.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $6.57 / $8.48
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.56 / $8.89 / $80.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $19.26 / $21.81
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $4.38 / $4.38
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $4.38 / $4.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.18 / $4.05