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Wisconsin rates for HCPCS V5264

Ear mold/insert, not disposable, any type

Facilitymedian $89 · 10th–90th $26–$2340%10%20%10th90th$89Professionalmedian $58 · 10th–90th $48–$890%50%10th90th$58$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $117.49 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $57.54 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $100,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $165.96 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $61.66 / $75.86
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $83.18 / $95.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $102.33 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $51.29 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $14.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $81.28 / $81.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $79.43 / $100.00