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West Virginia rates for HCPCS 49904

Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.00 / $1,403.76 / $2,142.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,466.18 / $1,659.26 / $1,807.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,577.78 / $1,577.78 / $1,577.78