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West Virginia rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,057.35 / $3,057.35 / $3,057.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.20 / $3,057.35 / $3,615.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,924.67 / $5,924.67 / $7,231.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,427.64 / $6,427.64 / $6,427.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,181.37 / $5,181.37 / $5,181.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,290.22 / $4,885.35 / $20,185.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,516.88 / $2,571.12 / $5,784.88