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Wisconsin rates for HCPCS A4634

Replacement bulb for therapeutic light box, tabletop model

Facilitymedian $158 · 10th–90th $91–$2340%20%40%10th90th$158Professionalmedian $158 · 10th–90th $13–$1580%50%10th$158$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $158.49 / $158.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $12.59 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $107.15 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $42.66 / $47.86
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $338.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $6.92 / $9.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $158.49 / $281.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $5,888.44 / $5,888.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $50.12