go back

Wisconsin rates for HCPCS J7100

Infusion Dextran 40 500 Ml (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.90 / $63.90 / $142.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.90 / $63.90 / $79.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.56 / $71.48 / $249.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.09 / $49.56 / $70.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.24 / $130.03 / $147.76
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.90 / $79.87 / $166.80
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.69 / $10.69 / $10.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.90 / $79.87 / $166.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.56 / $66.56 / $79.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $65.00 / $116.12
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.90 / $79.87 / $166.80
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.69 / $10.69 / $10.69
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.17 / $178.47 / $257.39
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.89 / $67.89 / $339.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.89 / $67.89 / $67.89
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.31 / $141.31 / $258.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.56 / $66.56 / $91.97