go back

Wisconsin rates for HCPCS C9734

Focused Ultrasound Ablation/Therapeutic Inter- Vention Other Than Uterine Leiomyomata With Magnetic Resonance (Mr) Guidance(Revised 07012013)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,399.57 / $11,399.57 / $11,399.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,979.00 / $15,055.00 / $22,609.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,080.00 / $7,318.00 / $10,000.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,918.00 / $6,477.00 / $8,384.00