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Wisconsin rates for HCPCS A7504

Filter for use in a tracheostoma heat and moisture exchange system, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.61 / $0.77
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.95 / $1.05 / $1.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.88 / $0.88 / $1.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.69 / $2.02 / $2.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $2.70 / $4.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $1.43 / $1.80
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.80 / $1.09
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.95 / $1.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $1.01 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.40 / $0.48 / $1.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.61 / $55.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.26 / $0.84 / $1.09
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.95 / $1.13
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.43 / $2.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $1.86 / $80.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.57 / $4.73
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.95 / $0.95
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $0.95 / $0.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.48 / $0.89