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West Virginia rates for HCPCS 67108

Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,550.00 / $3,642.03 / $12,932.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,187.76 / $1,491.35 / $2,386.71
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,225.20 / $1,335.66 / $1,455.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,126.85 / $1,224.35 / $1,446.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.51 / $1,318.51 / $1,318.51
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$131.16 / $131.16 / $131.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.40 / $1,509.12 / $8,784.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,902.86 / $11,608.21 / $16,909.04
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,589.96 / $1,776.94 / $2,730.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$922.96 / $1,509.13 / $2,319.61