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West Virginia rates for HCPCS Q4188

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.31 / $492.46 / $492.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $492.46 / $511.97
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $487.59 / $731.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $1,130.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.99 / $833.00 / $833.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $979.68