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Wisconsin rates for HCPCS G0103

Prostate Cancer Screening; Prostate Specific Antigen Test (Psa)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.92 / $151.90 / $281.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.55 / $19.30 / $71.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.52 / $50.21 / $53.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.08 / $9.08 / $79.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.12 / $49.96 / $51.92
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.30 / $19.30 / $19.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.17 / $62.13 / $95.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $27.66 / $59.09
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.14 / $18.88 / $24.72
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.56 / $20.56 / $20.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.88 / $92.69 / $197.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.59 / $20.18 / $93.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.66 / $53.30 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.14 / $18.88 / $24.72
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.56 / $20.56 / $20.56
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.46 / $47.33 / $66.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.61 / $38.61 / $95.74
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.16 / $10.16 / $10.23
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $41.12
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $105.43 / $105.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.04 / $15.45 / $52.92