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Virginia rates for HCPCS 31623

Brnchsc Brushing/Protected Brushings

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$220.83 / $2,561.71 / $8,294.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.05 / $293.56 / $570.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,060.00 / $3,693.00 / $4,290.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.70 / $246.82 / $373.49
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.53 / $236.92 / $3,426.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.38 / $276.39 / $513.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.19 / $312.23 / $385.08
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.78 / $294.33 / $538.62
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.00 / $407.00 / $674.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.12 / $191.12 / $1,683.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.10 / $415.29 / $1,683.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,911.00 / $3,276.00 / $5,340.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.25 / $404.03 / $598.36