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Wisconsin rates for HCPCS A4397

Irrigation Supply Sleeve

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.62 / $14.74 / $22.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.88 / $9.86 / $11.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.20 / $21.20 / $21.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.40 / $58.40 / $58.40
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.00 / $70.00 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.20 / $21.20 / $21.20