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Wisconsin rates for HCPCS A4358

Urinary Drainage Bag Leg Or Abdomen Vinyl With Or Without Tube With Straps Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.38 / $5.38 / $5.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.26 / $5.75 / $21.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.27 / $10.19 / $16.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.34 / $8.61 / $11.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.66 / $19.84 / $19.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.57 / $24.33 / $37.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.73 / $13.34 / $17.54
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $8.02 / $10.66
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.30 / $9.14 / $11.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $9.27 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.74 / $5.24 / $10.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $8.07 / $10.66
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.30 / $9.14 / $11.12
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.27 / $14.26 / $23.09
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.57 / $18.10 / $80.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.73 / $5.57 / $46.16
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.27 / $9.27 / $9.27
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.27 / $9.27 / $9.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $4.62 / $9.14