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Wisconsin rates for HCPCS A4280

Adhesive Skin Support Attachment For Use With External Breast Prosthesis Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.32 / $4.32 / $4.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.33 / $4.32 / $5.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.44 / $7.44 / $12.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $7.44 / $8.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.44 / $15.92 / $15.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.82 / $23.17 / $30.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $10.78 / $14.09
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.18 / $6.05 / $7.44
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.25 / $4.25 / $7.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.18 / $5.81 / $7.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $4.25 / $37.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.72 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.18 / $6.11 / $7.44
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.25 / $4.25 / $7.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.44 / $11.16 / $20.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.54 / $15.10 / $80.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $32.72 / $37.29
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.44 / $7.44 / $7.44
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.44 / $7.44 / $7.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $3.71 / $6.89