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Wisconsin rates for HCPCS L8048

Unspecified maxillofacial prosthesis, by report, provided by a nonphysician

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.59 / $1,051.59 / $1,051.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.86 / $893.86 / $1,083.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.84 / $590.84 / $590.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $85.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $590.84 / $1,051.59
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.86 / $1,051.59 / $1,051.59