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Virginia rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.86 / $591.97 / $5,743.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.90 / $127.99 / $239.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,735.00 / $2,390.00 / $2,954.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.03 / $120.55 / $183.71
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.83 / $64.83 / $974.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.45 / $125.45 / $125.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.73 / $139.53 / $236.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.34 / $154.71 / $184.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.87 / $127.50 / $233.62
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.00 / $182.00 / $277.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.50 / $110.89 / $1,098.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.18 / $191.45 / $1,098.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $926.62 / $2,364.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.54 / $154.21 / $258.39