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West 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
$840.54 / $3,702.43 / $3,702.43
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,181.11 / $9,837.10 / $9,837.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$852.91 / $949.03 / $1,033.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$913.23 / $913.23 / $913.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,322.34 / $8,322.34 / $27,411.26
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,020.12 / $8,128.49 / $20,905.99