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Wisconsin rates for HCPCS A4301

Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $33.88 / $33.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $33.88 / $33.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $33.11 / $33.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $3.09
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $34.67 / $52.48
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $45.71 / $58.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $34.67 / $954.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $85.11
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $69.18 / $954.99
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $39.81 / $40.74