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Wisconsin rates for HCPCS V2630

Anterior chamber intraocular lens

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $114.82 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $446.68 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $208.93 / $275.42
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $125.89 / $151.36
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $173.78 / $467.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $141.25 / $223.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $67.61 / $131.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $50.12 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $218.78 / $380.19
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $676.08
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $218.78 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $67.61 / $112.20