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West Virginia rates for HCPCS Q4219

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

Facilitymedian $78 · 10th–90th $78–$1,0230%50%90th$78Professionalmedian $1,000 · 10th–90th $117–$1,0230%20%40%10th90th$1,000$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $1,000.00 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $794.33