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West Virginia rates for HCPCS Q4159

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.62 / $207.00 / $207.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.96 / $207.00 / $215.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.96 / $204.96 / $307.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.96 / $204.96 / $475.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.35 / $1,076.67 / $1,076.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.96 / $204.96 / $204.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$777.30 / $777.30 / $777.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.96 / $204.96 / $1,266.59