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Wisconsin rates for HCPCS A4928

Surgical mask, per 20

Facilitymedian $1 · 10th–90th $1–$20%50%10th90th$1Professionalmedian $1 · 10th–90th $1–$10%50%$1$0.5$2.0$10.0$50.0

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
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $25.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.89 / $1.05 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.40 / $0.49 / $16.98
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $1.51
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.66 / $0.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.26 / $1.26 / $1.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
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 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $16.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $2.24