go back

Virginia rates for HCPCS 20696

App Mltpln Uni Xtrnl Fix Strtctc Adjmt 1st&Subsq

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.90 / $5,087.00 / $8,920.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,524.00 / $22,312.00 / $37,718.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,319.93 / $1,319.93 / $1,700.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,109.88 / $1,420.65 / $1,663.69
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,214.30 / $1,501.75 / $2,201.98
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,107.31 / $1,450.57 / $5,078.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,121.00 / $9,270.00 / $17,192.00