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Virginia rates for HCPCS 11004

Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.25 / $4,771.00 / $9,539.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$848.04 / $1,293.35 / $2,147.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.98 / $645.98 / $645.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.08 / $633.40 / $754.05
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$527.21 / $652.25 / $957.98
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$544.21 / $742.45 / $3,658.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.00 / $3,295.00 / $5,790.00