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West Virginia rates for HCPCS 64804

Sympathectomy, cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.96 / $1,400.00 / $1,909.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,086.41 / $1,250.71 / $1,474.21
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.71 / $1,479.06 / $1,611.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.84 / $1,432.40 / $1,432.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,366.34 / $1,366.34 / $1,366.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.10 / $1,492.64 / $2,919.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,474.93 / $5,474.93 / $5,474.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.48 / $1,159.92 / $1,909.87