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Wisconsin rates for HCPCS E1699

Replace Components For Hemodialysis And/Or Peritoneal Dialysis M

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.30 / $70.30 / $70.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.70 / $75.70 / $75.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $90.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.30 / $75.70 / $75.70