go back

Wisconsin rates for HCPCS A4313

Insertion Tray Without Drainage Bag With Indwelling Catheter Foley Type Three-Way For Continuous Irrigation (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.02 / $15.02 / $15.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.93 / $15.02 / $20.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.88 / $28.47 / $47.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.38 / $24.07 / $31.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.62 / $55.38 / $55.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.54 / $69.39 / $107.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.56 / $37.50 / $48.98
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $21.67 / $29.76
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.82 / $25.88 / $31.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.59 / $27.04 / $117.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.45 / $13.22 / $30.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.67 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $22.53 / $29.76
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.82 / $25.88 / $31.06
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.88 / $39.83 / $66.23
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.54 / $50.54 / $117.09
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.56 / $15.54 / $113.72
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.88 / $25.88 / $25.88
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.88 / $25.88 / $25.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $11.00 / $16.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.15 / $12.91 / $24.11