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Wisconsin rates for HCPCS L1300

Other Scoliosis Procedure, Body Jacket Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.53 / $1,047.53 / $1,047.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.70 / $1,130.26 / $1,442.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,076.54 / $2,284.19 / $3,779.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,868.88 / $1,931.18 / $2,554.14
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,493.86 / $4,443.80 / $4,443.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.46 / $4,292.67 / $8,667.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$932.55 / $3,009.38 / $3,930.01
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.11 / $1,571.30 / $2,388.02
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,188.98 / $2,076.54 / $2,509.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.53 / $2,076.54 / $10,083.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.05 / $1,095.33 / $2,344.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $1,038.65
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.11 / $1,571.30 / $2,388.02
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,188.98 / $2,076.54 / $2,509.19
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,076.54 / $3,195.74 / $5,633.77
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.46 / $4,055.74 / $10,083.62
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$932.55 / $1,277.46 / $12,143.39
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,076.54 / $2,076.54 / $2,076.54
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,658.08 / $2,076.54 / $2,076.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.38 / $1,085.06 / $1,985.60