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Wisconsin rates for HCPCS Q4051

Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $107.15 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $13.49 / $70.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $8.51
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $10.00 / $20.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $12.59 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $9.55 / $9.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,888.44 / $5,888.44 / $5,888.44
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $64.57 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $8.51