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West Virginia rates for HCPCS A2005

Microlyte Matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.50 / $144.50 / $144.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.50 / $155.13 / $221.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.41 / $293.41 / $293.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.38 / $216.38 / $1,227.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.04 / $420.04 / $420.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.93 / $254.57 / $271.52