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Wisconsin rates for HCPCS A4301

Implantable Access Total Catheter Port/Reservoir (E.G. Venous Arterial Epidural Or Subarachnoid Peritoneal Etc.) (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.49 / $34.49 / $34.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.18 / $34.49 / $34.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.34 / $21.34 / $32.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.66 / $34.49 / $62.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.66 / $34.49 / $950.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.66 / $34.49 / $62.08
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $69.03 / $950.51
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.43 / $39.69 / $40.50