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Wisconsin rates for HCPCS D0250

extra-oral - 2D projection radiographic image created using a stationary radiation source, and detector

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.98 / $19.95 / $25.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $38.90 / $72.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $29.51 / $2,454.71
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $13.80 / $13.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $22.91 / $48.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $281.84 / $281.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $58.88 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $57.54 / $81.28
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $281.84 / $281.84