go back

Wisconsin rates for HCPCS Q4125

Arthroflex Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.91 / $138.91 / $138.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.74 / $138.91 / $138.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $41.28 / $58.62
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.91 / $138.91 / $208.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.74 / $138.91 / $208.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.91 / $138.91 / $208.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,900.00 / $5,900.00 / $5,900.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $100.00