State prevailing rates

Please note that the CHAMPUS Maximum Allowable Charges (CMAC) take precedence over the state prevailing rates listed below.

Latest update: 03-13-2019
CPT code State Provider class Modifier Current pricing Effective date
0359T WI 01 00 $500.00 3/15/2016
0359T WI 04 00 $500.00 3/15/2016
0360T WI 01 00 $62.50 3/15/2016
0360T WI 04 00 $62.50 3/15/2016
0361T WI 01 00 $62.50 3/15/2016
0361T WI 04 00 $62.50 3/15/2016
0364T WI 01 00 $62.50 1/1/2018
0364T WI 04 00 $62.50 1/1/2018
0364T WI 01 00 $62.50 7/17/2018
0364T WI 04 00 $62.50 7/17/2018
0365T WI 01 00 $62.50 3/15/2016
0365T WI 04 00 $62.50 3/15/2016
0368T WI 01 00 $62.50 3/15/2016
0368T WI 04 00 $62.50 3/15/2016
0369T WI 01 00 $62.50 3/15/2016
0369T WI 04 00 $62.50 3/15/2016
0370T WI 01 00 $125.00 3/15/2016
0370T WI 04 00 $125.00 3/15/2016
41870 WI 01 00 $1,251.00 1/1/2018
41870 WI 04 00 $1,251.00 1/1/2018
41870 WI 01 00 $1,251.00 7/17/2018
41870 WI 04 00 $1,251.00 7/17/2018
74300 WI 01 00 $766.25 4/19/2017
74300 WI 01 00 $1,630.00 1/1/2018
74300 WI 04 00 $326.75 1/1/2018
74300 WI 01 00 $1,630.00 7/17/2018
74300 WI 04 00 $326.75 7/17/2018
74300 WI 01 00 $747.00 1/1/2019
74300 WI 04 00 $747.00 1/1/2019
74300 WI 01 TC $308.31 1/1/2018
74300 WI 04 TC $308.31 1/1/2018
74300 WI 01 TC $308.31 7/17/2018
74300 WI 04 TC $308.31 7/17/2018
74328 WI 01 00 $1,283.00 1/1/2018
74328 WI 04 00 $599.20 1/1/2018
74328 WI 01 00 $1,283.00 7/17/2018
74328 WI 04 00 $599.20 7/17/2018
74328 WI 01 00 $771.00 1/1/2019
74328 WI 04 00 $771.00 1/1/2019
74328 WI 01 TC $566.42 1/1/2018
74328 WI 04 TC $566.42 1/1/2018
74328 WI 01 TC $566.42 7/17/2018
74328 WI 04 TC $566.42 7/17/2018
75894 WI 01 00 $901.00 1/1/2019
75894 WI 04 00 $901.00 1/1/2019
75970 WI 01 00 $3,270.00 1/1/2019
75970 WI 04 00 $3,270.00 1/1/2019
76001 WI 01 00 $1,343.00 4/19/2017
76001 WI 01 00 $1,361.90 1/1/2018
76001 WI 04 00 $616.50 1/1/2018
76001 WI 01 00 $1,361.90 7/17/2018
76001 WI 04 00 $616.50 7/17/2018
76001 WI 01 00 $1,470.00 1/1/2019
76001 WI 04 00 $1,470.00 1/1/2019
76001 WI 01 TC $584.62 1/1/2018
76001 WI 04 TC $584.62 1/1/2018
76001 WI 01 TC $584.62 7/17/2018
76001 WI 04 TC $584.62 7/17/2018
77386 WI 01 00 $2,931.00 3/15/2016
77386 WI 04 00 $2,931.00 3/15/2016
80300 WI 01 00 $208.50 3/15/2016
80300 WI 04 00 $208.50 3/15/2016
80301 WI 01 00 $385.00 3/15/2016
80301 WI 04 00 $385.00 3/15/2016
80302 WI 01 00 $350.00 3/15/2016
80302 WI 04 00 $350.00 3/15/2016
80303 WI 01 00 $200.70 3/15/2016
80303 WI 04 00 $200.70 3/15/2016
80320 WI 01 00 $183.75 3/15/2016
80320 WI 04 00 $183.75 3/15/2016
80324 WI 01 00 $125.00 3/15/2016
80324 WI 04 00 $125.00 3/15/2016
80326 WI 01 00 $175.00 3/15/2016
80326 WI 04 00 $175.00 3/15/2016
80329 WI 01 00 $208.00 3/15/2016
80329 WI 04 00 $208.00 3/15/2016
80337 WI 01 00 $271.00 3/15/2016
80337 WI 04 00 $271.00 3/15/2016
80346 WI 01 00 $76.00 3/15/2016
80346 WI 04 00 $76.00 3/15/2016
80348 WI 01 00 $110.00 3/15/2016
80348 WI 04 00 $110.00 3/15/2016
80349 WI 01 00 $138.00 3/15/2016
80349 WI 04 00 $138.00 3/15/2016
80354 WI 01 00 $110.00 3/15/2016
80354 WI 04 00 $110.00 3/15/2016
80355 WI 01 00 $62.05 3/15/2016
80355 WI 04 00 $62.05 3/15/2016
80356 WI 01 00 $66.35 3/15/2016
80356 WI 04 00 $66.35 3/15/2016
80359 WI 01 00 $125.00 3/15/2016
80359 WI 04 00 $125.00 3/15/2016
80365 WI 01 00 $110.00 3/15/2016
80365 WI 04 00 $110.00 3/15/2016
80368 WI 01 00 $66.00 3/15/2016
80368 WI 04 00 $66.00 3/15/2016
80370 WI 01 00 $154.00 3/15/2016
80370 WI 04 00 $154.00 3/15/2016
80372 WI 01 00 $139.00 3/15/2016
80372 WI 04 00 $139.00 3/15/2016
80373 WI 01 00 $129.00 3/15/2016
80373 WI 04 00 $129.00 3/15/2016
86860 WI 01 00 $215.50 1/1/2018
86860 WI 04 00 $215.50 1/1/2018
86860 WI 01 00 $215.50 7/17/2018
86860 WI 04 00 $215.50 7/17/2018
86921 WI 01 00 $44.00 1/1/2018
86921 WI 04 00 $44.00 1/1/2018
86921 WI 01 00 $44.00 7/17/2018
86921 WI 04 00 $44.00 7/17/2018
86960 WI 01 00 $64.46 3/15/2016
86960 WI 04 00 $62.64 3/15/2016
90681 WI 01 00 $256.00 1/1/2019
90681 WI 04 00 $256.00 1/1/2019
90696 WI 01 00 $143.00 1/1/2019
90696 WI 04 00 $143.00 1/1/2019
90736 WI 01 00 $235.51 7/19/2017
90736 WI 04 00 $235.51 7/19/2017
90736 WI 01 00 $254.35 7/20/2017
90736 WI 04 00 $254.35 7/20/2017
90736 WI 01 00 $254.35 1/1/2018
90736 WI 04 00 $254.35 1/1/2018
90736 WI 01 NU $235.51 10/19/2016
90736 WI 04 NU $235.51 10/19/2016
92921 WI 01 00 $3,846.50 1/1/2018
92921 WI 04 00 $3,846.50 1/1/2018
92921 WI 01 00 $3,846.50 7/17/2018
92921 WI 04 00 $3,846.50 7/17/2018
92929 WI 01 00 $5,030.00 1/1/2018
92929 WI 04 00 $5,030.00 1/1/2018
92929 WI 01 00 $5,030.00 7/17/2018
92929 WI 04 00 $5,030.00 7/17/2018
93299 WI 01 00 $428.75 4/19/2017
93299 WI 04 00 $428.75 4/19/2017
93299 WI 01 00 $428.75 1/1/2018
93299 WI 04 00 $428.75 1/1/2018
93299 WI 01 00 $428.75 7/17/2018
93299 WI 04 00 $428.75 7/17/2018
93299 WI 01 00 $1,635.00 1/1/2019
93299 WI 04 00 $1,635.00 1/1/2019
93620 WI 01 00 $20,438.00 1/1/2018
93620 WI 04 00 $2,782.00 1/1/2018
93620 WI 01 00 $20,438.00 7/17/2018
93620 WI 04 00 $2,782.00 7/17/2018
93620 WI 01 TC $2,162.67 1/1/2018
93620 WI 04 TC $2,162.67 1/1/2018
93620 WI 01 TC $2,162.67 7/17/2018
93620 WI 04 TC $2,162.67 7/17/2018
93621 WI 01 00 $8,011.25 1/1/2018
93621 WI 04 00 $3,038.00 1/1/2018
93621 WI 01 00 $8,011.25 7/17/2018
93621 WI 04 00 $3,038.00 7/17/2018
93621 WI 01 00 $8,016.00 1/1/2019
93621 WI 04 00 $8,016.00 1/1/2019
93621 WI 01 TC $2,930.52 1/1/2018
93621 WI 04 TC $2,930.52 1/1/2018
93621 WI 01 TC $2,930.52 7/17/2018
93621 WI 04 TC $2,930.52 7/17/2018
93623 WI 01 00 $5,265.00 1/1/2018
93623 WI 04 00 $4,144.50 1/1/2018
93623 WI 01 00 $5,265.00 7/17/2018
93623 WI 04 00 $4,144.50 7/17/2018
93623 WI 01 00 $5,799.00 1/1/2019
93623 WI 04 00 $5,799.00 1/1/2019
93662 WI 01 00 $4,977.00 1/1/2019
93662 WI 04 00 $4,977.00 1/1/2019
99000 WI 01 00 $37.00 4/19/2017
99000 WI 04 00 $37.00 4/19/2017
99000 WI 01 00 $39.00 1/1/2018
99000 WI 04 00 $39.00 1/1/2018
99000 WI 01 00 $39.00 7/17/2018
99000 WI 04 00 $39.00 7/17/2018
99001 WI 01 00 $48.06 4/19/2017
99001 WI 04 00 $46.00 4/19/2017
99001 WI 01 00 $48.06 1/1/2018
99001 WI 04 00 $46.00 1/1/2018
99001 WI 01 00 $48.06 7/17/2018
99001 WI 04 00 $46.00 7/17/2018
99001 WI 01 00 $43.60 1/1/2019
99001 WI 04 00 $43.60 1/1/2019
99002 WI 01 00 $45.00 1/1/2018
99002 WI 04 00 $45.00 1/1/2018
99002 WI 01 00 $45.00 7/17/2018
99002 WI 04 00 $45.00 7/17/2018
99071 WI 01 00 $51.25 3/15/2016
99071 WI 04 00 $47.75 3/15/2016
99082 WI 01 00 $100.00 4/19/2017
99082 WI 01 00 $100.00 1/1/2018
99082 WI 04 00 $50.00 1/1/2018
99082 WI 01 00 $100.00 7/17/2018
99082 WI 04 00 $50.00 7/17/2018
99455 WI 01 00 $385.00 3/15/2016
99455 WI 04 00 $381.00 3/15/2016
99504 WI 01 00 $75.00 1/1/2018
99504 WI 04 00 $75.00 1/1/2018
99504 WI 01 00 $75.00 7/17/2018
99504 WI 04 00 $75.00 7/17/2018
99510 WI 01 00 $140.00 3/15/2016
99510 WI 04 00 $140.00 3/15/2016
A0431 WI 01 00 $3,522.19 12/10/2015
A0431 WI 04 00 $3,522.19 12/10/2015
A0431 WI 01 00 $2,544.78 1/1/2018
A0431 WI 04 00 $2,544.78 1/1/2018
A0431 WI 01 00 $2,544.78 4/9/2018
A0431 WI 04 00 $2,544.78 4/9/2018
A0431 WI 01 00 $2,163.06 1/1/2019
A0431 WI 04 00 $2,163.06 1/1/2019
A0436 WI 01 00 $43.35 12/10/2015
A0436 WI 04 00 $43.35 12/10/2015
A0436 WI 01 00 $31.32 1/1/2018
A0436 WI 04 00 $31.32 1/1/2018
A0436 WI 01 00 $31.32 4/9/2018
A0436 WI 04 00 $31.32 4/9/2018
A0436 WI 01 00 $26.62 1/1/2019
A0436 WI 04 00 $26.62 1/1/2019
A4206 WI 01 00 $0.40 1/1/2018
A4206 WI 04 00 $0.40 1/1/2018
A4206 WI 01 00 $0.40 7/17/2018
A4206 WI 04 00 $0.40 7/17/2018
A4207 WI 01 00 $0.40 1/1/2018
A4207 WI 04 00 $0.40 1/1/2018
A4207 WI 01 00 $0.40 7/17/2018
A4207 WI 04 00 $0.40 7/17/2018
A4208 WI 01 00 $8.00 1/1/2018
A4208 WI 04 00 $8.00 1/1/2018
A4208 WI 01 00 $8.00 7/17/2018
A4208 WI 04 00 $8.00 7/17/2018
A4209 WI 01 00 $5.00 4/19/2017
A4209 WI 04 00 $5.00 4/19/2017
A4209 WI 01 00 $5.00 1/1/2018
A4209 WI 04 00 $5.00 1/1/2018
A4209 WI 01 00 $5.00 7/17/2018
A4209 WI 04 00 $5.00 7/17/2018
A4209 WI 01 00 $35.00 1/1/2019
A4209 WI 04 00 $35.00 1/1/2019
A4210 WI 01 00 $12.95 1/1/2018
A4210 WI 04 00 $12.95 1/1/2018
A4210 WI 01 00 $12.95 7/17/2018
A4210 WI 04 00 $12.95 7/17/2018
A4211 WI 01 00 $216.00 1/1/2018
A4211 WI 04 00 $216.00 1/1/2018
A4211 WI 01 00 $216.00 7/17/2018
A4211 WI 04 00 $216.00 7/17/2018
A4212 WI 01 00 $19.00 4/19/2017
A4212 WI 04 00 $19.00 4/19/2017
A4212 WI 01 00 $20.00 1/1/2018
A4212 WI 04 00 $20.00 1/1/2018
A4212 WI 01 00 $20.00 7/17/2018
A4212 WI 04 00 $20.00 7/17/2018
A4213 WI 01 00 $24.00 4/19/2017
A4213 WI 04 00 $24.00 4/19/2017
A4213 WI 01 00 $24.00 1/1/2018
A4213 WI 04 00 $24.00 1/1/2018
A4213 WI 01 00 $24.00 7/17/2018
A4213 WI 04 00 $24.00 7/17/2018
A4213 WI 01 00 $1.95 1/1/2019
A4213 WI 04 00 $1.95 1/1/2019
A4215 WI 01 00 $25.00 4/19/2017
A4215 WI 04 00 $25.00 4/19/2017
A4215 WI 01 00 $30.00 1/1/2018
A4215 WI 04 00 $30.00 1/1/2018
A4215 WI 01 00 $30.00 7/17/2018
A4215 WI 04 00 $30.00 7/17/2018
A4215 WI 01 00 $2.00 1/1/2019
A4215 WI 04 00 $2.00 1/1/2019
A4218 WI 01 00 $19.50 1/1/2018
A4218 WI 04 00 $19.50 1/1/2018
A4218 WI 01 00 $19.50 7/17/2018
A4218 WI 04 00 $19.50 7/17/2018
A4220 WI 01 00 $104.00 1/1/2018
A4220 WI 04 00 $104.00 1/1/2018
A4220 WI 01 00 $104.00 7/17/2018
A4220 WI 04 00 $104.00 7/17/2018
A4223 WI 01 00 $407.70 4/19/2017
A4223 WI 04 00 $407.70 4/19/2017
A4223 WI 01 00 $407.70 1/1/2018
A4223 WI 04 00 $407.70 1/1/2018
A4223 WI 01 00 $407.70 7/17/2018
A4223 WI 04 00 $407.70 7/17/2018
A4223 WI 01 00 $9.00 1/1/2019
A4223 WI 04 00 $9.00 1/1/2019
A4223 WI 01 NU $407.70 1/1/2018
A4223 WI 04 NU $407.70 1/1/2018
A4223 WI 01 NU $407.70 7/17/2018
A4223 WI 04 NU $407.70 7/17/2018
A4230 WI 01 00 $26.00 4/19/2017
A4230 WI 04 00 $26.00 4/19/2017
A4230 WI 01 00 $34.84 1/1/2018
A4230 WI 04 00 $34.84 1/1/2018
A4230 WI 01 00 $34.84 7/17/2018
A4230 WI 04 00 $34.84 7/17/2018
A4232 WI 01 00 $7.24 1/1/2018
A4232 WI 04 00 $7.24 1/1/2018
A4232 WI 01 00 $7.24 7/17/2018
A4232 WI 04 00 $7.24 7/17/2018
A4244 WI 01 00 $1.80 1/1/2018
A4244 WI 04 00 $1.80 1/1/2018
A4244 WI 01 00 $1.80 7/17/2018
A4244 WI 04 00 $1.80 7/17/2018
A4245 WI 01 00 $4.47 4/19/2017
A4245 WI 04 00 $4.47 4/19/2017
A4245 WI 01 00 $7.32 1/1/2018
A4245 WI 04 00 $7.32 1/1/2018
A4245 WI 01 00 $7.32 7/17/2018
A4245 WI 04 00 $7.32 7/17/2018
A4246 WI 01 00 $8.00 1/1/2018
A4246 WI 04 00 $8.00 1/1/2018
A4246 WI 01 00 $8.00 7/17/2018
A4246 WI 04 00 $8.00 7/17/2018
A4247 WI 01 00 $6.36 1/1/2018
A4247 WI 04 00 $6.36 1/1/2018
A4247 WI 01 00 $6.36 7/17/2018
A4247 WI 04 00 $6.36 7/17/2018
A4248 WI 01 00 $21.00 1/1/2018
A4248 WI 04 00 $21.00 1/1/2018
A4248 WI 01 00 $21.00 7/17/2018
A4248 WI 04 00 $21.00 7/17/2018
A4250 WI 01 00 $41.30 1/1/2018
A4250 WI 04 00 $41.30 1/1/2018
A4250 WI 01 00 $41.30 7/17/2018
A4250 WI 04 00 $41.30 7/17/2018
A4263 WI 01 00 $100.00 1/1/2018
A4263 WI 04 00 $100.00 1/1/2018
A4263 WI 01 00 $100.00 7/17/2018
A4263 WI 04 00 $100.00 7/17/2018
A4270 WI 01 00 $42.00 1/1/2018
A4270 WI 04 00 $42.00 1/1/2018
A4270 WI 01 00 $42.00 7/17/2018
A4270 WI 04 00 $42.00 7/17/2018
A4281 WI 01 00 $12.63 1/1/2018
A4281 WI 04 00 $12.63 1/1/2018
A4281 WI 01 00 $12.63 7/17/2018
A4281 WI 04 00 $12.63 7/17/2018
A4281 WI 01 00 $20.45 1/1/2019
A4281 WI 04 00 $20.45 1/1/2019
A4282 WI 01 00 $29.99 1/1/2018
A4282 WI 04 00 $29.99 1/1/2018
A4282 WI 01 00 $29.99 7/17/2018
A4282 WI 04 00 $29.99 7/17/2018
A4282 WI 01 00 $37.49 1/1/2019
A4282 WI 04 00 $37.49 1/1/2019
A4283 WI 01 00 $6.99 1/1/2018
A4283 WI 04 00 $6.99 1/1/2018
A4283 WI 01 00 $6.99 7/17/2018
A4283 WI 04 00 $6.99 7/17/2018
A4283 WI 01 00 $45.00 1/1/2019
A4283 WI 04 00 $45.00 1/1/2019
A4284 WI 01 00 $14.40 1/1/2018
A4284 WI 04 00 $14.40 1/1/2018
A4284 WI 01 00 $14.40 7/17/2018
A4284 WI 04 00 $14.40 7/17/2018
A4284 WI 01 00 $75.00 1/1/2019
A4284 WI 04 00 $75.00 1/1/2019
A4285 WI 01 00 $38.01 1/1/2018
A4285 WI 04 00 $38.01 1/1/2018
A4285 WI 01 00 $38.01 7/17/2018
A4285 WI 04 00 $38.01 7/17/2018
A4285 WI 01 00 $15.81 1/1/2019
A4285 WI 04 00 $15.81 1/1/2019
A4300 WI 01 00 $8.75 1/1/2018
A4300 WI 04 00 $8.75 1/1/2018
A4300 WI 01 00 $8.75 7/17/2018
A4300 WI 04 00 $8.75 7/17/2018
A4305 WI 01 00 $100.70 4/19/2017
A4305 WI 04 00 $100.70 4/19/2017
A4305 WI 01 00 $100.70 1/1/2018
A4305 WI 04 00 $100.70 1/1/2018
A4305 WI 01 00 $100.70 7/17/2018
A4305 WI 04 00 $100.70 7/17/2018
A4305 WI 01 00 $27.75 1/1/2019
A4305 WI 04 00 $27.75 1/1/2019
A4306 WI 01 00 $1,140.50 1/1/2018
A4306 WI 04 00 $1,140.50 1/1/2018
A4306 WI 01 00 $1,140.50 7/17/2018
A4306 WI 04 00 $1,140.50 7/17/2018
A4450 WI 01 00 $1.00 1/1/2019
A4450 WI 04 00 $1.00 1/1/2019
A4452 WI 01 00 $1.00 1/1/2019
A4452 WI 04 00 $1.00 1/1/2019
A4465 WI 01 00 $4.95 1/1/2018
A4465 WI 04 00 $4.95 1/1/2018
A4465 WI 01 00 $4.95 7/17/2018
A4465 WI 04 00 $4.95 7/17/2018
A4466 WI 01 00 $103.00 4/21/2017
A4466 WI 04 00 $103.00 4/21/2017
A4470 WI 01 00 $4.95 1/1/2018
A4470 WI 04 00 $4.95 1/1/2018
A4470 WI 01 00 $4.95 7/17/2018
A4470 WI 04 00 $4.95 7/17/2018
A4483 WI 01 00 $8.38 1/1/2018
A4483 WI 04 00 $8.38 1/1/2018
A4483 WI 01 00 $8.38 7/17/2018
A4483 WI 04 00 $8.38 7/17/2018
A4483 WI 01 00 $14.48 1/1/2019
A4483 WI 04 00 $14.48 1/1/2019
A4490 WI 01 00 $19.00 1/1/2018
A4490 WI 04 00 $19.00 1/1/2018
A4490 WI 01 00 $19.00 7/17/2018
A4490 WI 04 00 $19.00 7/17/2018
A4495 WI 01 00 $21.25 1/1/2018
A4495 WI 04 00 $21.25 1/1/2018
A4495 WI 01 00 $21.25 7/17/2018
A4495 WI 04 00 $21.25 7/17/2018
A4500 WI 01 00 $19.00 1/1/2018
A4500 WI 04 00 $19.00 1/1/2018
A4500 WI 01 00 $19.00 7/17/2018
A4500 WI 04 00 $19.00 7/17/2018
A4510 WI 01 00 $80.00 1/1/2018
A4510 WI 04 00 $80.00 1/1/2018
A4510 WI 01 00 $80.00 7/17/2018
A4510 WI 04 00 $80.00 7/17/2018
A4550 WI 01 00 $99.00 4/19/2017
A4550 WI 04 00 $99.00 4/19/2017
A4550 WI 01 00 $99.00 1/1/2018
A4550 WI 04 00 $99.00 1/1/2018
A4550 WI 01 00 $99.00 7/17/2018
A4550 WI 04 00 $99.00 7/17/2018
A4550 WI 01 00 $165.00 1/1/2019
A4550 WI 04 00 $165.00 1/1/2019
A4554 WI 01 00 $0.47 3/15/2016
A4554 WI 04 00 $0.47 3/15/2016
A4566 WI 01 00 $206.75 1/1/2018
A4566 WI 04 00 $206.75 1/1/2018
A4566 WI 01 00 $206.75 7/17/2018
A4566 WI 04 00 $206.75 7/17/2018
A4570 WI 01 00 $56.00 4/19/2017
A4570 WI 04 00 $56.00 4/19/2017
A4570 WI 01 00 $56.00 1/1/2018
A4570 WI 04 00 $56.00 1/1/2018
A4570 WI 01 00 $56.00 7/17/2018
A4570 WI 04 00 $56.00 7/17/2018
A4570 WI 01 00 $45.00 1/1/2019
A4570 WI 04 00 $45.00 1/1/2019
A4580 WI 01 00 $75.00 1/1/2018
A4580 WI 04 00 $75.00 1/1/2018
A4580 WI 01 00 $75.00 7/17/2018
A4580 WI 04 00 $75.00 7/17/2018
A4590 WI 01 00 $79.00 4/19/2017
A4590 WI 04 00 $79.00 4/19/2017
A4590 WI 01 00 $79.00 1/1/2018
A4590 WI 04 00 $79.00 1/1/2018
A4590 WI 01 00 $79.00 7/17/2018
A4590 WI 04 00 $79.00 7/17/2018
A4590 WI 01 00 $185.00 1/1/2019
A4590 WI 04 00 $185.00 1/1/2019
A4606 WI 01 00 $63.61 1/1/2018
A4606 WI 04 00 $63.61 1/1/2018
A4606 WI 01 00 $63.61 7/17/2018
A4606 WI 04 00 $63.61 7/17/2018
A4606 WI 01 00 $67.20 1/1/2019
A4606 WI 04 00 $67.20 1/1/2019
A4606 WI 01 NU $67.20 1/1/2019
A4606 WI 04 NU $67.20 1/1/2019
A4627 WI 01 00 $88.00 4/19/2017
A4627 WI 04 00 $88.00 4/19/2017
A4627 WI 01 00 $92.00 1/1/2018
A4627 WI 04 00 $92.00 1/1/2018
A4627 WI 01 00 $92.00 7/17/2018
A4627 WI 04 00 $92.00 7/17/2018
A4627 WI 01 00 $56.00 1/1/2019
A4627 WI 04 00 $56.00 1/1/2019
A4648 WI 01 00 $536.00 4/19/2017
A4648 WI 04 00 $536.00 4/19/2017
A4648 WI 01 00 $579.68 1/1/2018
A4648 WI 04 00 $579.68 1/1/2018
A4648 WI 01 00 $579.68 7/17/2018
A4648 WI 04 00 $579.68 7/17/2018
A4648 WI 01 00 $570.00 1/1/2019
A4648 WI 04 00 $570.00 1/1/2019
A4657 WI 01 00 $74.06 4/19/2017
A4657 WI 04 00 $74.06 4/19/2017
A4657 WI 01 00 $74.06 1/1/2018
A4657 WI 04 00 $74.06 1/1/2018
A4657 WI 01 00 $74.06 7/17/2018
A4657 WI 04 00 $74.06 7/17/2018
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H2019 WI 04 00 $12.50 1/1/2018
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J0604 WI 04 00 $2.72 3/1/2019
J7296 WI 01 00 $2,060.00 3/1/2019
J7296 WI 04 00 $2,060.00 3/1/2019
J7300 WI 01 00 $1,630.00 1/1/2019
J7300 WI 04 00 $1,630.00 1/1/2019
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K0462 WI 04 RR $322.00 7/17/2018
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K0739 WI 04 00 $14.87 12/1/2015
K0739 WI 01 00 $15.26 1/1/2018
K0739 WI 04 00 $15.26 1/1/2018
K0739 WI 01 00 $15.26 1/24/2018
K0739 WI 04 00 $15.26 1/24/2018
K0739 WI 01 00 $15.70 1/1/2019
K0739 WI 04 00 $15.70 1/1/2019
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L3215 WI 04 00 $76.64 3/15/2016
L3216 WI 01 00 $122.00 3/15/2016
L3216 WI 04 00 $122.00 3/15/2016
L3217 WI 01 00 $95.00 3/15/2016
L3217 WI 04 00 $95.00 3/15/2016
L3219 WI 01 00 $88.16 3/15/2016
L3219 WI 04 00 $88.16 3/15/2016
L3221 WI 01 00 $163.80 3/15/2016
L3221 WI 04 00 $163.80 3/15/2016
L3222 WI 01 00 $115.00 3/15/2016
L3222 WI 04 00 $115.00 3/15/2016
L3230 WI 01 00 $274.56 3/15/2016
L3230 WI 04 00 $274.56 3/15/2016
L3250 WI 01 00 $231.77 3/15/2016
L3250 WI 04 00 $231.77 3/15/2016
L3251 WI 01 00 $288.00 3/15/2016
L3251 WI 04 00 $288.00 3/15/2016
L3252 WI 01 00 $187.20 3/15/2016
L3252 WI 04 00 $187.20 3/15/2016
L3253 WI 01 00 $89.00 3/15/2016
L3253 WI 04 00 $89.00 3/15/2016
L3260 WI 01 00 $52.00 4/19/2017
L3260 WI 04 00 $52.00 4/19/2017
L3260 WI 01 00 $52.00 1/1/2018
L3260 WI 04 00 $52.00 1/1/2018
L3260 WI 01 00 $52.00 7/17/2018
L3260 WI 04 00 $52.00 7/17/2018
L3260 WI 01 00 $70.00 1/1/2019
L3260 WI 04 00 $70.00 1/1/2019
L3265 WI 01 00 $35.00 3/15/2016
L3265 WI 04 00 $35.00 3/15/2016
L3320 WI 01 00 $60.00 1/1/2018
L3320 WI 04 00 $60.00 1/1/2018
L3320 WI 01 00 $60.00 7/17/2018
L3320 WI 04 00 $60.00 7/17/2018
L3485 WI 01 00 $19.00 1/1/2018
L3485 WI 04 00 $19.00 1/1/2018
L3485 WI 01 00 $19.00 7/17/2018
L3485 WI 04 00 $19.00 7/17/2018
L4002 WI 01 00 $63.00 1/1/2018
L4002 WI 04 00 $63.00 1/1/2018
L4002 WI 01 00 $63.00 7/17/2018
L4002 WI 04 00 $63.00 7/17/2018
L4205 WI 01 00 $22.13 12/1/2015
L4205 WI 04 00 $22.13 12/1/2015
L4205 WI 01 00 $22.71 1/1/2018
L4205 WI 04 00 $22.71 1/1/2018
L4205 WI 01 00 $22.71 1/24/2018
L4205 WI 04 00 $22.71 1/24/2018
L4205 WI 01 00 $23.37 1/1/2019
L4205 WI 04 00 $23.37 1/1/2019
L4210 WI 01 00 $72.00 1/1/2018
L4210 WI 04 00 $72.00 1/1/2018
L4210 WI 01 00 $72.00 7/17/2018
L4210 WI 04 00 $72.00 7/17/2018
L4210 WI 01 00 $67.00 1/1/2019
L4210 WI 04 00 $67.00 1/1/2019
L7520 WI 01 00 $30.08 12/1/2015
L7520 WI 04 00 $30.08 12/1/2015
L7520 WI 01 00 $30.87 1/1/2018
L7520 WI 04 00 $30.87 1/1/2018
L7520 WI 01 00 $30.87 1/24/2018
L7520 WI 04 00 $30.87 1/24/2018
L7520 WI 01 00 $31.77 1/1/2019
L7520 WI 04 00 $31.77 1/1/2019
L8010 WI 01 00 $43.43 1/1/2018
L8010 WI 04 00 $43.43 1/1/2018
L8010 WI 01 00 $43.43 7/17/2018
L8010 WI 04 00 $43.43 7/17/2018
L8680 WI 01 00 $4,000.00 1/1/2018
L8680 WI 04 00 $4,000.00 1/1/2018
L8680 WI 01 00 $4,000.00 7/17/2018
L8680 WI 04 00 $4,000.00 7/17/2018
L8687 WI 01 00 $50,757.00 1/1/2018
L8687 WI 04 00 $50,757.00 1/1/2018
L8687 WI 01 00 $50,757.00 7/17/2018
L8687 WI 04 00 $50,757.00 7/17/2018
P9016 WI 01 00 $435.00 4/19/2017
P9016 WI 01 00 $528.00 1/1/2018
P9016 WI 04 00 $435.00 1/1/2018
P9016 WI 01 00 $528.00 7/17/2018
P9016 WI 04 00 $435.00 7/17/2018
P9016 WI 01 00 $571.00 1/1/2019
P9016 WI 04 00 $571.00 1/1/2019
P9017 WI 01 00 $201.50 1/1/2018
P9017 WI 04 00 $201.50 1/1/2018
P9017 WI 01 00 $201.50 7/17/2018
P9017 WI 04 00 $201.50 7/17/2018
P9021 WI 01 00 $544.00 1/1/2018
P9021 WI 04 00 $544.00 1/1/2018
P9021 WI 01 00 $544.00 7/17/2018
P9021 WI 04 00 $544.00 7/17/2018
P9035 WI 01 00 $1,768.90 1/1/2018
P9035 WI 04 00 $1,387.71 1/1/2018
P9035 WI 01 00 $1,768.90 7/17/2018
P9035 WI 04 00 $1,387.71 7/17/2018
P9035 WI 01 00 $1,530.25 1/1/2019
P9035 WI 04 00 $1,530.25 1/1/2019
P9037 WI 01 00 $1,158.24 1/1/2018
P9037 WI 04 00 $570.00 1/1/2018
P9037 WI 01 00 $1,158.24 7/17/2018
P9037 WI 04 00 $570.00 7/17/2018
P9040 WI 01 00 $499.05 1/1/2018
P9040 WI 04 00 $394.20 1/1/2018
P9040 WI 01 00 $499.05 7/17/2018
P9040 WI 04 00 $394.20 7/17/2018
P9040 WI 01 00 $830.50 1/1/2019
P9040 WI 04 00 $830.50 1/1/2019
P9044 WI 01 00 $771.25 1/1/2018
P9044 WI 04 00 $771.25 1/1/2018
P9044 WI 01 00 $771.25 7/17/2018
P9044 WI 04 00 $771.25 7/17/2018
P9053 WI 01 00 $863.00 1/1/2018
P9053 WI 04 00 $863.00 1/1/2018
P9053 WI 01 00 $863.00 7/17/2018
P9053 WI 04 00 $863.00 7/17/2018
P9058 WI 01 00 $508.05 1/1/2018
P9058 WI 04 00 $508.05 1/1/2018
P9058 WI 01 00 $508.05 7/17/2018
P9058 WI 04 00 $508.05 7/17/2018
P9059 WI 01 00 $130.00 1/1/2018
P9059 WI 04 00 $130.00 1/1/2018
P9059 WI 01 00 $130.00 7/17/2018
P9059 WI 04 00 $130.00 7/17/2018
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P9603 WI 04 00 $1.06 1/1/2018
P9603 WI 01 00 $1.06 7/17/2018
P9603 WI 04 00 $1.06 7/17/2018
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P9604 WI 04 00 $6.75 1/1/2018
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P9604 WI 04 00 $31.90 1/1/2019
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Q0081 WI 04 00 $82.60 1/1/2018
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Q0081 WI 04 00 $82.60 7/17/2018
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Q4050 WI 04 00 $50.00 1/1/2019
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Q4051 WI 04 00 $57.00 1/1/2019
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Q9954 WI 04 00 $21.00 7/17/2018
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Q9962 WI 01 00 $6.00 7/17/2018
Q9962 WI 04 00 $6.00 7/17/2018
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Q9964 WI 04 00 $2.00 1/1/2018
Q9964 WI 01 00 $2.00 7/17/2018
Q9964 WI 04 00 $2.00 7/17/2018
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Q9968 WI 04 00 $79.77 1/1/2019
Q9969 WI 01 00 $20.00 1/1/2019
Q9969 WI 04 00 $20.00 1/1/2019
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Q9984 WI 04 00 $1,424.90 3/1/2019
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R0070 WI 04 00 $110.00 1/1/2018
R0070 WI 01 00 $110.00 7/17/2018
R0070 WI 04 00 $110.00 7/17/2018
R0075 WI 01 00 $55.00 1/1/2018
R0075 WI 04 00 $55.00 1/1/2018
R0075 WI 01 00 $55.00 7/17/2018
R0075 WI 04 00 $55.00 7/17/2018
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S0189 WI 04 00 $331.51 1/1/2019
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S0395 WI 04 00 $87.50 3/15/2016
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S0630 WI 04 00 $77.75 3/15/2016
S1015 WI 01 00 $7.92 3/15/2016
S1015 WI 04 00 $7.92 3/15/2016
S1040 WI 01 00 $3,200.00 1/1/2018
S1040 WI 04 00 $3,200.00 1/1/2018
S1040 WI 01 00 $3,200.00 7/17/2018
S1040 WI 04 00 $3,200.00 7/17/2018
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S5108 WI 04 00 $31.25 1/1/2018
S5108 WI 01 00 $31.25 7/17/2018
S5108 WI 04 00 $31.25 7/17/2018
S5110 WI 01 00 $31.25 1/1/2018
S5110 WI 04 00 $31.25 1/1/2018
S5110 WI 01 00 $31.25 7/17/2018
S5110 WI 04 00 $31.25 7/17/2018
S5115 WI 01 00 $31.25 1/1/2018
S5115 WI 04 00 $31.25 1/1/2018
S5115 WI 01 00 $31.25 7/17/2018
S5115 WI 04 00 $31.25 7/17/2018
S9430 WI 01 00 $500.00 4/19/2017
S9430 WI 01 00 $500.00 1/1/2018
S9430 WI 04 00 $201.25 1/1/2018
S9430 WI 01 00 $500.00 7/17/2018
S9430 WI 04 00 $201.25 7/17/2018
S9480 WI 01 00 $251.00 2/24/2016
S9480 WI 04 00 $251.00 2/24/2016
S9480 WI 01 00 $265.00 9/18/2017
S9480 WI 04 00 $265.00 9/18/2017
S9480 WI 01 00 $265.00 1/1/2018
S9480 WI 04 00 $265.00 1/1/2018
S9480 WI 01 00 $272.00 10/1/2018
S9480 WI 04 00 $272.00 10/1/2018
S9484 WI 01 00 $91.50 3/15/2016
S9484 WI 04 00 $91.50 3/15/2016
S9502 WI 01 00 $350.00 3/15/2016
S9502 WI 04 00 $350.00 3/15/2016
T1016 WI 01 00 $19.01 4/19/2017
T1016 WI 04 00 $17.52 4/19/2017
T1016 WI 01 00 $19.01 1/1/2018
T1016 WI 04 00 $17.52 1/1/2018
T1016 WI 01 00 $19.01 7/17/2018
T1016 WI 04 00 $17.52 7/17/2018
T1017 WI 01 00 $31.82 3/15/2016
T1017 WI 04 00 $31.82 3/15/2016
T1019 WI 01 00 $5.38 3/15/2016
T1019 WI 04 00 $5.38 3/15/2016
T1502 WI 01 00 $80.00 1/1/2018
T1502 WI 04 00 $80.00 1/1/2018
T1502 WI 01 00 $80.00 7/17/2018
T1502 WI 04 00 $80.00 7/17/2018
V2025 WI 01 00 $182.22 3/15/2016
V2025 WI 04 00 $182.22 3/15/2016
V2702 WI 01 00 $10.00 3/15/2016
V2702 WI 04 00 $10.00 3/15/2016
V2781 WI 01 00 $260.00 4/19/2017
V2781 WI 04 00 $260.00 4/19/2017
V2781 WI 01 00 $260.00 1/1/2018
V2781 WI 04 00 $260.00 1/1/2018
V2781 WI 01 00 $260.00 7/17/2018
V2781 WI 04 00 $260.00 7/17/2018
V2781 WI 01 00 $132.50 1/1/2019
V2781 WI 04 00 $132.50 1/1/2019
V2787 WI 01 00 $500.00 3/15/2016
V2787 WI 04 00 $500.00 3/15/2016
V2788 WI 01 00 $1,425.00 3/15/2016
V2788 WI 04 00 $1,425.00 3/15/2016
V5050 WI 01 00 $800.00 1/1/2018
V5050 WI 04 00 $800.00 1/1/2018
V5050 WI 01 00 $800.00 7/17/2018
V5050 WI 04 00 $800.00 7/17/2018
V5160 WI 01 00 $1,300.00 1/1/2018
V5160 WI 04 00 $1,300.00 1/1/2018
V5160 WI 01 00 $1,300.00 7/17/2018
V5160 WI 04 00 $1,300.00 7/17/2018
V5241 WI 01 00 $650.00 1/1/2018
V5241 WI 04 00 $650.00 1/1/2018
V5241 WI 01 00 $650.00 7/17/2018
V5241 WI 04 00 $650.00 7/17/2018
V5241 WI 01 00 $715.50 1/1/2019
V5241 WI 04 00 $715.50 1/1/2019
V5257 WI 01 00 $2,600.00 1/1/2018
V5257 WI 04 00 $2,600.00 1/1/2018
V5257 WI 01 00 $2,600.00 7/17/2018
V5257 WI 04 00 $2,600.00 7/17/2018
V5257 WI 01 00 $2,688.00 1/1/2019
V5257 WI 04 00 $2,688.00 1/1/2019
V5258 WI 01 00 $2,730.00 1/1/2018
V5258 WI 04 00 $2,730.00 1/1/2018
V5258 WI 01 00 $2,730.00 7/17/2018
V5258 WI 04 00 $2,730.00 7/17/2018
V5261 WI 01 00 $5,040.00 4/19/2017
V5261 WI 04 00 $5,040.00 4/19/2017
V5261 WI 01 00 $5,040.00 1/1/2018
V5261 WI 04 00 $5,040.00 1/1/2018
V5261 WI 01 00 $5,040.00 7/17/2018
V5261 WI 04 00 $5,040.00 7/17/2018
V5261 WI 01 00 $5,000.00 1/1/2019
V5261 WI 04 00 $5,000.00 1/1/2019
V5264 WI 01 00 $118.75 4/19/2017
V5264 WI 04 00 $118.75 4/19/2017
V5264 WI 01 00 $118.75 1/1/2018
V5264 WI 04 00 $118.75 1/1/2018
V5264 WI 01 00 $118.75 7/17/2018
V5264 WI 04 00 $118.75 7/17/2018
V5264 WI 01 00 $94.00 1/1/2019
V5264 WI 04 00 $94.00 1/1/2019
V5265 WI 01 00 $60.00 1/1/2018
V5265 WI 04 00 $60.00 1/1/2018
V5265 WI 01 00 $60.00 7/17/2018
V5265 WI 04 00 $60.00 7/17/2018
V5266 WI 01 00 $30.00 4/19/2017
V5266 WI 04 00 $30.00 4/19/2017
V5266 WI 01 00 $30.00 1/1/2018
V5266 WI 04 00 $30.00 1/1/2018
V5266 WI 01 00 $30.00 7/17/2018
V5266 WI 04 00 $30.00 7/17/2018
V5266 WI 01 00 $3.75 1/1/2019
V5266 WI 04 00 $3.75 1/1/2019
V5267 WI 01 00 $91.00 4/19/2017
V5267 WI 04 00 $91.00 4/19/2017
V5267 WI 01 00 $270.00 1/1/2018
V5267 WI 04 00 $270.00 1/1/2018
V5267 WI 01 00 $270.00 7/17/2018
V5267 WI 04 00 $270.00 7/17/2018
V5275 WI 01 00 $60.00 1/1/2018
V5275 WI 04 00 $60.00 1/1/2018
V5275 WI 01 00 $60.00 7/17/2018
V5275 WI 04 00 $60.00 7/17/2018