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West Virginia rates for HCPCS 14021

Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $794.33 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $741.31 / $1,445.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $891.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $954.99 / $4,570.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,703.96 / $25,703.96 / $25,703.96
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $5,754.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $851.14 / $1,230.27