go back

West 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
$84.84 / $489.70 / $778.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.87 / $115.76 / $162.36
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.09 / $88.91 / $96.88
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.11 / $86.11 / $86.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.45 / $125.45 / $125.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $132.54 / $323.80
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.74 / $342.45 / $565.60
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.01 / $103.01 / $103.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$557.10 / $557.10 / $557.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.56 / $170.73 / $299.60