go back

Wisconsin rates for HCPCS C8914

Magnetic Resonance Angiography Without Contrast Followed By With Contrast Lower Extremity (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.75 / $318.75 / $318.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.75 / $318.75 / $425.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.00 / $2,221.19 / $2,221.19
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.75 / $318.75 / $478.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.75 / $318.75 / $573.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,490.62 / $1,490.62 / $1,490.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $70.00 / $619.67
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.75 / $318.75 / $478.13
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,040.19 / $1,040.19 / $1,040.19
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.00 / $800.00 / $800.00