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Wisconsin rates for HCPCS A4737

Injectable anesthetic, for dialysis, per 10 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $223.87
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $4.27
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $10.00 / $13.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $5.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $54.95 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76