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Wisconsin rates for HCPCS A6412

Eye patch, occlusive, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.54 / $1.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $1.05 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.71 / $5.13
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.28 / $0.55
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.43 / $0.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.30 / $0.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.22 / $10.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.37 / $0.76 / $1.10
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $7.41 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $1.70 / $10.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.20 / $0.35