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West Virginia rates for HCPCS L4030

Replace Quadrilateral Socket Brim, Custom Fitted

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.86 / $293.86 / $293.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.93 / $281.23 / $293.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.72 / $812.60 / $1,023.84
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.72 / $398.16 / $682.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.88 / $477.88 / $757.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.85 / $348.85 / $3,176.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.84 / $315.04 / $494.07