go back

West Virginia rates for HCPCS 15758

Free fascial flap with microvascular anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.00 / $1,700.00 / $2,172.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,210.35 / $2,652.42 / $2,889.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,553.94 / $2,553.94 / $2,553.94
Cigna
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$1,572.60 / $1,572.60 / $1,572.60