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West Virginia rates for HCPCS 19371

Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $741.31 / $2,290.87
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$6,165.95 / $6,165.95 / $6,165.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$1,445.44 / $1,445.44 / $1,445.44
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $9,549.93 / $10,964.78
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$18,197.01 / $18,197.01 / $19,054.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $10,964.78