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Wisconsin rates for HCPCS A6504

Compression burn garment, glove to wrist, custom fabricated

Facilitymedian $126 · 10th–90th $89–$1,8200%20%40%10th90th$126Professionalmedian $89 · 10th–90th $89–$910%50%90th$89$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $151.36 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,584.89 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $630.96 / $724.44
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $162.18
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $446.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $162.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,888.44 / $5,888.44 / $5,888.44
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $251.19
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $144.54