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Virginia rates for HCPCS B4087

Gastrostomy/jejunostomy tube, standard, any material, any type, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $33.11 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $28.18 / $33.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $32.36 / $34.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $26.30 / $37.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $18.62 / $162.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $38.90 / $63.10
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $53.70 / $53.70
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $31.62 / $46.77
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $23.44
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $38.02 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.44 / $38.02 / $10,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $33.11 / $51.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $33.11 / $54.95