go back

West Virginia rates for HCPCS Q4165

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $43.65 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $45.71 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $125.89 / $4,168.69