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Virginia rates for HCPCS 19380

Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$987.00 / $4,007.00 / $8,920.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,875.50 / $4,972.50 / $10,769.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,955.00 / $11,210.00 / $17,424.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.57 / $927.08 / $1,143.40
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$824.14 / $1,041.48 / $1,470.93
Medcost
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,412.82 / $1,730.57 / $2,313.85
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.67 / $1,023.37 / $6,585.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,693.00 / $11,671.00 / $21,639.00