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West Virginia rates for HCPCS 21215

Graft, bone; mandible (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $3,715.35 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,737.80 / $4,570.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $1,000.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $3,801.89 / $18,620.87
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,079.46 / $7,079.46 / $7,079.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $16,595.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,380.38 / $5,128.61