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Wisconsin rates for HCPCS G0105

Colorectal cancer screening; colonoscopy on individual at high risk

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$308.29 / $3,119.00 / $5,642.82
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$81.20 / $81.20 / $154.15
Aetna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$32.47 / $61.66 / $153.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.50 / $318.20 / $2,490.50
Aetna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$35.39 / $78.73 / $179.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,139.00 / $2,419.00 / $4,441.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.53 / $480.28 / $1,302.14
Anthem BCBS
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$126.51 / $239.90 / $665.67
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.72 / $165.58 / $260.85
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.82 / $227.34 / $463.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$906.53 / $1,059.34 / $1,625.07
Cigna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$194.61 / $194.61 / $194.61
Cigna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$48.65 / $48.65 / $48.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.69 / $468.28 / $1,240.75
Cigna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$132.94 / $245.51 / $656.16
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.30 / $308.29 / $439.20
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.50 / $277.50 / $277.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.46 / $317.91 / $2,738.06
Medica
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$663.66 / $663.66 / $663.66
Medica
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$165.92 / $165.92 / $165.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.08 / $1,037.08 / $2,206.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.76 / $274.03 / $588.93
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.30 / $308.29 / $439.20
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.50 / $277.50 / $277.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.11 / $693.70 / $1,136.28
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.26 / $1,063.59 / $1,063.59
Quartz
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$194.61 / $663.66 / $663.66
Quartz
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$48.65 / $165.92 / $165.92
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.45 / $1,182.00 / $2,206.53
Quartz
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$346.02 / $346.02 / $656.16
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.69 / $910.51 / $1,721.54
Security Health
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$143.49 / $237.72 / $514.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,367.00 / $2,910.00 / $4,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.63 / $702.31 / $1,440.53