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West Virginia rates for HCPCS 15110

Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$681.60 / $789.60 / $1,600.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$755.40 / $846.46 / $922.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,211.27 / $1,211.27 / $1,211.27