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Wisconsin rates for HCPCS B4088

Gastrostomy/Jejunostomy Tube Standard Any Material Any Type Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.01 / $29.01 / $29.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.08 / $29.01 / $121.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.79 / $37.79 / $62.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.14 / $35.14 / $41.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.01 / $80.87 / $80.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.12 / $115.83 / $177.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.50 / $53.44 / $71.09
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.08 / $37.79 / $39.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.01 / $37.79 / $184.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.60 / $53.30 / $131.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $90.00 / $125.90
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.08 / $37.79 / $39.68
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.79 / $65.40 / $109.40
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.38 / $76.70 / $184.63
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.50 / $25.50 / $25.50
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.45 / $44.45 / $44.45
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.77 / $47.77 / $47.77
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.45 / $44.45 / $44.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.89 / $54.89 / $54.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.36 / $44.71 / $119.28