go back

Wisconsin rates for HCPCS A4929

Tourniquet for dialysis, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.25 / $0.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.43 / $1.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.05 / $1.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.47 / $0.69
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.27 / $0.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.19 / $0.27 / $0.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.22 / $2.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.27 / $0.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.77 / $1.08
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.63 / $0.73 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $1.70 / $2.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.20 / $0.35