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Wisconsin rates for HCPCS A4652

Microcapillary tube sealant

Facilitymedian $0 · 10th–90th $0–$40%50%90th$0Professionalmedian $4 · 10th–90th $0–$300%20%10th90th$4$0.2$1.0$5.0$20.0$100.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.98 / $15.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.35 / $0.35 / $0.35
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.12 / $0.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.12 / $0.12 / $2.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $6.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.23 / $6.76