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West Virginia rates for HCPCS 0102T

Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.20 / $382.20 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.20 / $331.47 / $384.31
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,012.50 / $4,781.25 / $9,832.42
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119,998.80 / $119,998.80 / $119,998.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.70 / $395.70 / $395.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,442.19 / $1,442.19 / $1,442.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.98 / $302.30 / $464.85