go back

West Virginia rates for HCPCS 40761

Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $1,905.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $1,380.38
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,445.44 / $6,606.93
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
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
$870.96 / $1,258.93 / $1,698.24