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West Virginia rates for HCPCS Q2004

Bladder Calculi Irrig Sol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.22 / $103.22 / $121.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.79 / $103.22 / $103.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.38 / $12.38 / $18.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.22 / $103.22 / $103.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.82 / $11.82 / $150.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.15 / $101.19 / $121.43