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Wisconsin rates for HCPCS A4354

Insertion tray with drainage bag but without catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $10.00 / $14.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $16.60 / $27.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $17.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $51.29 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $23.99 / $31.62
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $10.72 / $16.98
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $32.36 / $40.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.12 / $13.18 / $34.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $8.32 / $109.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $25.12 / $44.67
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $24.55 / $112.20
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $16.60 / $16.60
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $16.60 / $16.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $8.13 / $13.18