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Wisconsin rates for HCPCS L5688

Addition To Lower Extremity Below Knee Waist Belt Webbing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.22 / $37.22 / $37.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.54 / $37.22 / $61.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.80 / $81.18 / $134.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.42 / $68.63 / $90.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.09 / $157.93 / $157.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.81 / $152.91 / $307.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.44 / $106.88 / $139.68
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.61 / $55.85 / $84.87
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.25 / $73.80 / $97.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.22 / $73.80 / $392.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.29 / $49.30 / $83.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.44 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.61 / $56.96 / $84.87
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.25 / $73.80 / $97.76
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.80 / $113.56 / $219.81
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.81 / $144.13 / $392.56
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.44 / $45.81 / $576.36
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.80 / $73.80 / $73.80
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.80 / $73.80 / $73.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.40 / $48.77 / $73.80