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West Virginia rates for HCPCS 21142

Rcnstj Midface Lefort I 2 Pieces W/O Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,029.31 / $28,046.53 / $28,046.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,414.69 / $2,168.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,309.63 / $1,433.57 / $1,712.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$780.85 / $1,521.98 / $1,521.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,531.60 / $1,531.60 / $1,531.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,307.82 / $1,902.48 / $4,102.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,019.37 / $1,461.87 / $2,106.69