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West Virginia rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $812.83 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $741.31 / $912.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $933.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $954.99 / $4,168.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $851.14 / $1,230.27