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Wisconsin rates for HCPCS C1765

Adhesion Barrier

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $3.46 / $1,246.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.46 / $3.46 / $424.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.98 / $767.98 / $1,389.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.98 / $217.98 / $225.00
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $3.46 / $424.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $3.46 / $424.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.85 / $375.85 / $375.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $3.46 / $424.92
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,900.00 / $5,900.00 / $5,900.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $100.00 / $465.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.98 / $217.98 / $217.98