go back

Virginia rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.02 / $11.02 / $12.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.65 / $11.02 / $13.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.50 / $6.50 / $9.90
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.94 / $9.94 / $9.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.89 / $20.89 / $20.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $7.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.16 / $20.86 / $28.53
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.02 / $14.00 / $22.31
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $27.00 / $41.78
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.75 / $15.94 / $30.31
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.75 / $15.94 / $30.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.02 / $8.89 / $14.66