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West Virginia rates for HCPCS 21210

Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$729.74 / $1,400.00 / $2,448.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.74 / $1,602.22 / $3,469.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.06 / $809.14 / $966.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.89 / $858.89 / $942.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,297.44 / $1,297.44 / $1,297.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.82 / $1,836.57 / $4,665.33
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,399.49 / $15,399.49 / $15,399.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.48 / $1,954.31 / $3,162.32