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Wisconsin rates for HCPCS A4930

Gloves Sterile Per Pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.51 / $0.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.80 / $2.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.80 / $2.11 / $3.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $1.19 / $1.41
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.38 / $0.53 / $0.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.55 / $1.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.43 / $5.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.45 / $55.00 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.39 / $0.54 / $0.94
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.85 / $1.53 / $2.16
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.75 / $1.28 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.11 / $3.40 / $5.30
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.77 / $0.77 / $0.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.41 / $0.70