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
$85.11 / $489.78 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $120.23 / $229.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $97.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $131.83 / $1,096.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $354.81 / $562.34
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $102.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $562.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $144.54 / $245.47