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Wisconsin rates for HCPCS J0716

Injection Centruroides Immune F(Ab)2 Up To 120 Milligrams

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,036.26 / $5,036.26 / $11,230.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,036.26 / $5,036.26 / $6,295.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,013.09 / $10,474.67 / $10,864.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,246.10 / $5,246.10 / $5,351.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,884.92 / $8,860.84 / $12,665.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,718.88 / $3,830.44 / $5,351.02
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,036.26 / $6,295.32 / $6,295.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,859.01 / $5,036.26 / $6,295.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,246.10 / $5,246.10 / $6,819.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $18,840.24
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,036.26 / $6,295.32 / $6,295.32
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,317.80 / $25,317.80 / $25,317.80
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,351.02 / $5,351.02 / $5,351.02
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,141.13 / $4,141.13 / $7,571.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,855.30 / $4,855.30 / $11,361.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,246.10 / $5,246.10 / $6,819.93