State prevailing rates

Please note that the CHAMPUS Maximum Allowable Charges (CMAC) take precedence over the state prevailing rates listed below.

Latest update: 08-01-2018
CPT code State Provider class Modifier Current pricing Effective date Past pricing Past effective date
74300 WV 01 00 $1,072.00 04/20/17 $911.00 08/21/15
74300 WV 01 TC $308.64 05/17/17
74300 WV 04 00 $327.25 05/17/17
74300 WV 04 TC $308.64 05/17/17
90736 WV 01 00 $254.35 07/20/17
90736 WV 04 00 $254.35 07/20/17
99000 WV 01 00 $25.00 04/20/17
99000 WV 04 00 $25.00 04/20/17
A0431 WV 01 00 $2,114.12 04/09/18 $2,487.20 12/08/16
A0431 WV 01 00 $2,926.13 12/10/15
A0431 WV 04 00 $2,114.12 04/09/18 $2,487.20 12/08/16
A0431 WV 04 00 $2,926.13 12/10/15
A0436 WV 01 00 $21.40 04/09/18 $25.18 12/08/16
A0436 WV 01 00 $29.62 12/10/15
A0436 WV 04 00 $21.40 04/09/18 $25.18 12/08/16
A0436 WV 04 00 $29.62 12/10/15
A4206 WV 01 00 $.40 05/17/17
A4206 WV 04 00 $.40 05/17/17
A4207 WV 01 00 $.40 05/17/17
A4207 WV 04 00 $.40 05/17/17
A4208 WV 01 00 $.40 05/17/17
A4208 WV 04 00 $.40 05/17/17
A4209 WV 01 00 $15.00 05/17/17
A4209 WV 04 00 $15.00 05/17/17
A4210 WV 01 00 $12.95 05/17/17
A4210 WV 04 00 $12.95 05/17/17
A4211 WV 01 00 $11.50 05/17/17
A4211 WV 04 00 $11.50 05/17/17
A4212 WV 01 00 $15.00 05/17/17
A4212 WV 04 00 $10.50 05/17/17
A4213 WV 01 00 $5.00 05/17/17
A4213 WV 04 00 $5.00 05/17/17
A4215 WV 01 00 $13.00 05/17/17
A4215 WV 04 00 $13.00 05/17/17
A4218 WV 01 00 $.58 05/17/17
A4218 WV 04 00 $.58 05/17/17
A4223 WV 01 00 $350.00 04/20/17 $120.00 08/29/15
A4223 WV 04 00 $350.00 04/20/17 $120.00 08/29/15
A4244 WV 01 00 $1.80 05/17/17
A4244 WV 04 00 $1.80 05/17/17
A4245 WV 01 00 $3.50 05/17/17
A4245 WV 04 00 $3.50 05/17/17
A4246 WV 01 00 $8.00 05/17/17
A4246 WV 04 00 $8.00 05/17/17
A4247 WV 01 00 $1.75 05/17/17
A4247 WV 04 00 $1.75 05/17/17
A4250 WV 01 00 $41.30 05/17/17
A4250 WV 04 00 $41.30 05/17/17
A4262 WV 01 00 $74.00 05/17/17
A4262 WV 04 00 $74.00 05/17/17
A4263 WV 01 00 $80.00 05/17/17
A4263 WV 04 00 $80.00 05/17/17
A4300 WV 01 00 $15.00 05/17/17
A4300 WV 04 00 $15.00 05/17/17
A4305 WV 01 00 $15.00 05/17/17
A4305 WV 04 00 $15.00 05/17/17
A4465 WV 01 00 $4.95 05/17/17
A4465 WV 04 00 $4.95 05/17/17
A4470 WV 01 00 $4.95 05/17/17
A4470 WV 04 00 $4.95 05/17/17
A4483 WV 01 00 $10.50 05/17/17
A4483 WV 04 00 $10.50 05/17/17
A4490 WV 01 00 $19.00 05/17/17
A4490 WV 04 00 $19.00 05/17/17
A4495 WV 01 00 $21.25 05/17/17
A4495 WV 04 00 $21.25 05/17/17
A4500 WV 01 00 $19.00 05/17/17
A4500 WV 04 00 $19.00 05/17/17
A4510 WV 01 00 $80.00 05/17/17
A4510 WV 04 00 $80.00 05/17/17
A4550 WV 01 00 $60.00 04/20/17
A4550 WV 04 00 $60.00 04/20/17 $50.00 08/29/15
A4570 WV 01 00 $25.00 05/17/17
A4570 WV 04 00 $25.00 05/17/17
A4580 WV 01 00 $43.50 05/17/17
A4580 WV 04 00 $43.50 05/17/17
A4590 WV 01 00 $79.00 05/17/17
A4590 WV 04 00 $79.00 05/17/17
A4606 WV 01 00 $147.58 05/17/17
A4606 WV 04 00 $147.58 05/17/17
A4627 WV 01 00 $65.00 05/17/17 $25.00 08/29/15
A4627 WV 04 00 $65.00 05/17/17 $25.00 08/29/15
A4648 WV 01 00 $337.50 05/17/17
A4648 WV 04 00 $337.50 05/17/17
A4657 WV 01 00 $90.25 04/20/17 $55.64 08/31/15
A4657 WV 04 00 $90.25 04/20/17 $55.64 08/31/15
A4660 WV 01 00 $79.95 05/17/17
A4660 WV 04 00 $79.95 05/17/17
A4663 WV 01 00 $34.00 05/17/17
A4663 WV 04 00 $34.00 05/17/17
A4680 WV 01 00 $21.55 05/17/17
A4680 WV 04 00 $21.55 05/17/17
A4690 WV 01 00 $461.25 05/17/17
A4690 WV 04 00 $461.25 05/17/17
A4750 WV 01 00 $6.00 05/17/17
A4750 WV 04 00 $6.00 05/17/17
A4755 WV 01 00 $10.25 05/17/17
A4755 WV 04 00 $10.25 05/17/17
A4760 WV 01 00 $7.00 05/17/17
A4760 WV 04 00 $7.00 05/17/17
A4765 WV 01 00 $2.00 05/17/17
A4765 WV 04 00 $2.00 05/17/17
A4770 WV 01 00 $160.00 05/17/17
A4770 WV 04 00 $160.00 05/17/17
A4771 WV 01 00 $10.60 05/17/17
A4771 WV 04 00 $10.60 05/17/17
A4772 WV 01 00 $90.20 05/17/17
A4772 WV 04 00 $90.20 05/17/17
A4773 WV 01 00 $85.00 05/17/17
A4773 WV 04 00 $85.00 05/17/17
A4860 WV 01 00 $3.00 05/17/17
A4860 WV 04 00 $3.00 05/17/17
A4918 WV 01 00 $7.10 05/17/17
A4918 WV 04 00 $7.10 05/17/17
A4927 WV 01 00 $9.00 05/17/17
A4927 WV 04 00 $9.00 05/17/17
A6208 WV 01 00 $67.11 05/17/17
A6208 WV 04 00 $67.11 05/17/17
A6213 WV 01 00 $9.80 05/17/17
A6213 WV 04 00 $9.80 05/17/17
A6217 WV 01 00 $2.00 05/17/17
A6217 WV 04 00 $2.00 05/17/17
A6250 WV 01 00 $16.00 05/17/17
A6250 WV 04 00 $16.00 05/17/17
A6451 WV 01 00 $1.99 05/17/17
A6451 WV 04 00 $1.99 05/17/17
A6530 WV 01 00 $62.80 05/17/17
A6530 WV 04 00 $62.80 05/17/17
A6533 WV 01 00 $70.00 05/17/17
A6533 WV 04 00 $70.00 05/17/17
A6534 WV 01 00 $52.50 05/17/17
A6534 WV 04 00 $52.50 05/17/17
A6539 WV 01 00 $140.00 05/17/17
A6539 WV 04 00 $140.00 05/17/17
A9270 WV 01 00 $11.45 03/15/16
A9270 WV 04 00 $11.45 03/15/16
A9282 WV 01 00 $2,000.00 05/17/17
A9282 WV 04 00 $2,000.00 05/17/17
A9500 WV 01 00 $511.21 04/20/17
A9500 WV 04 00 $361.35 04/20/17 $300.00 09/01/15
A9502 WV 01 00 $275.00 04/20/17
A9502 WV 04 00 $222.75 04/20/17
A9503 WV 01 00 $130.00 04/20/17
A9503 WV 04 00 $69.80 05/17/17
A9505 WV 01 00 $115.00 05/17/17
A9505 WV 04 00 $100.00 05/17/17
A9507 WV 01 00 $3,244.35 05/17/17
A9507 WV 04 00 $3,244.35 05/17/17
A9510 WV 01 00 $125.00 05/17/17 $117.00 09/03/15
A9510 WV 04 00 $117.00 05/17/17
A9512 WV 01 00 $10.00 05/17/17
A9512 WV 04 00 $1.89 05/17/17
A9516 WV 01 00 $229.95 04/20/17 $190.00 09/03/15
A9516 WV 04 00 $68.45 05/17/17
A9517 WV 01 00 $43.13 05/17/17
A9517 WV 04 00 $33.31 05/17/17
A9521 WV 01 00 $567.61 05/17/17
A9521 WV 04 00 $567.61 05/17/17
A9528 WV 01 00 $88.66 05/17/17
A9528 WV 04 00 $88.66 05/17/17
A9530 WV 01 00 $28.91 05/17/17
A9530 WV 04 00 $28.91 05/17/17
A9537 WV 01 00 $229.00 04/20/17 $184.50 09/03/15
A9537 WV 04 00 $229.00 04/20/17 $59.54 09/03/15
A9538 WV 01 00 $24.70 05/17/17
A9538 WV 04 00 $24.70 05/17/17
A9539 WV 01 00 $16.25 05/17/17
A9539 WV 04 00 $16.25 05/17/17
A9540 WV 01 00 $73.00 05/17/17
A9540 WV 04 00 $57.00 05/17/17
A9541 WV 01 00 $243.50 04/20/17
A9541 WV 04 00 $75.35 05/17/17
A9542 WV 01 00 $2,769.63 05/17/17
A9542 WV 04 00 $2,769.63 05/17/17
A9551 WV 01 00 $126.63 05/17/17
A9551 WV 04 00 $126.63 05/17/17
A9552 WV 01 00 $1,789.00 04/20/17 $1,383.00 09/16/15
A9552 WV 04 00 $313.00 05/17/17
A9556 WV 01 00 $32.04 05/17/17
A9556 WV 04 00 $32.04 05/17/17
A9558 WV 01 00 $38.96 05/17/17
A9558 WV 04 00 $38.96 05/17/17
A9560 WV 01 00 $114.00 05/17/17
A9560 WV 04 00 $114.00 05/17/17
A9561 WV 01 00 $327.00 05/17/17
A9561 WV 04 00 $34.56 05/17/17
A9562 WV 01 00 $932.00 05/17/17
A9562 WV 04 00 $445.51 05/17/17
A9567 WV 01 00 $342.75 05/17/17
A9567 WV 04 00 $342.75 05/17/17
A9572 WV 01 00 $65.00 05/17/17
A9572 WV 04 00 $65.00 05/17/17
A9600 WV 01 00 $1,014.13 05/17/17
A9600 WV 04 00 $1,014.13 05/17/17
A9901 WV 01 00 $10.00 05/17/17
A9901 WV 04 00 $10.00 05/17/17
B4160 WV 01 00 $5.29 05/17/17
B4160 WV 04 00 $5.29 05/17/17
B4161 WV 01 00 $9.98 05/17/17
B4161 WV 04 00 $9.98 05/17/17
B5200 WV 01 00 $4.94 05/17/17
B5200 WV 04 00 $4.94 05/17/17
C1713 WV 01 00 $1,514.00 05/17/17
C1713 WV 04 00 $1,514.00 05/17/17
C1725 WV 01 00 $1,962.00 05/17/17
C1725 WV 04 00 $1,962.00 05/17/17
C1726 WV 01 00 $1,873.72 05/17/17
C1726 WV 04 00 $1,873.72 05/17/17
C1727 WV 01 00 $1,968.00 05/17/17
C1727 WV 04 00 $1,968.00 05/17/17
C1729 WV 01 00 $305.50 05/17/17
C1729 WV 04 00 $305.50 05/17/17
C1730 WV 01 00 $2,369.00 05/17/17
C1730 WV 04 00 $2,369.00 05/17/17
C1732 WV 01 00 $5,829.00 05/17/17
C1732 WV 04 00 $5,829.00 05/17/17
C1733 WV 01 00 $3,144.00 05/17/17
C1733 WV 04 00 $3,144.00 05/17/17
C1751 WV 01 00 $847.00 05/17/17
C1751 WV 04 00 $847.00 05/17/17
C1753 WV 01 00 $3,941.00 05/17/17
C1753 WV 04 00 $3,941.00 05/17/17
C1758 WV 01 00 $110.38 05/17/17 $99.95 09/17/15
C1758 WV 04 00 $110.38 05/17/17 $99.95 09/17/15
C1760 WV 01 00 $1,737.75 05/17/17
C1760 WV 04 00 $1,737.75 05/17/17
C1762 WV 01 00 $5,056.50 05/17/17
C1762 WV 04 00 $5,056.50 05/17/17
C1763 WV 01 00 $3,247.00 05/17/17
C1763 WV 04 00 $3,247.00 05/17/17
C1765 WV 01 00 $1,492.60 05/17/17
C1765 WV 04 00 $1,492.60 05/17/17
C1766 WV 01 00 $428.00 05/17/17
C1766 WV 04 00 $428.00 05/17/17
C1769 WV 01 00 $355.00 05/17/17
C1769 WV 04 00 $355.00 05/17/17
C1771 WV 01 00 $3,003.00 05/17/17
C1771 WV 04 00 $3,003.00 05/17/17
C1776 WV 01 00 $3,476.00 05/17/17
C1776 WV 04 00 $3,476.00 05/17/17
C1778 WV 01 00 $7,080.00 05/17/17
C1778 WV 04 00 $7,080.00 05/17/17
C1780 WV 01 00 $1,013.12 05/17/17
C1780 WV 04 00 $1,013.12 05/17/17
C1781 WV 01 00 $1,758.00 05/17/17
C1781 WV 04 00 $1,758.00 05/17/17
C1788 WV 01 00 $2,284.00 05/17/17 $1,971.80 09/21/15
C1788 WV 04 00 $2,284.00 05/17/17 $1,971.80 09/21/15
C1874 WV 01 00 $6,463.00 05/17/17
C1874 WV 04 00 $6,463.00 05/17/17
C1876 WV 01 00 $3,607.00 05/17/17
C1876 WV 04 00 $3,607.00 05/17/17
C1887 WV 01 00 $419.00 05/17/17
C1887 WV 04 00 $419.00 05/17/17
C1893 WV 01 00 $513.09 05/17/17
C1893 WV 04 00 $513.09 05/17/17
C1894 WV 01 00 $278.00 05/17/17
C1894 WV 04 00 $278.00 05/17/17
C2615 WV 01 00 $815.50 05/17/17
C2615 WV 04 00 $815.50 05/17/17
C2617 WV 01 00 $856.80 05/17/17
C2617 WV 04 00 $856.80 05/17/17
C2629 WV 01 00 $232.00 05/17/17
C2629 WV 04 00 $232.00 05/17/17
C8908 WV 01 00 $3,300.50 05/17/17
C8908 WV 04 00 $2,289.00 05/17/17
C8924 WV 01 00 $614.58 05/17/17
C8924 WV 04 00 $814.58 05/17/17
C8929 WV 01 00 $1,555.20 05/17/17
C8929 WV 04 00 $1,555.20 05/17/17
C8957 WV 01 00 $706.00 05/17/17
C8957 WV 04 00 $706.00 05/17/17
C9113 WV 01 00 $233.95 05/17/17
C9113 WV 04 00 $28.08 05/17/17
C9600 WV 01 00 $14,445.00 04/20/17
C9600 WV 04 00 $11,249.00 05/17/17
D0120 WV 01 00 $46.00 05/17/17
D0120 WV 04 00 $27.00 05/17/17
D0140 WV 01 00 $75.00 05/17/17
D0140 WV 04 00 $75.00 05/17/17
D0150 WV 01 00 $65.00 05/17/17
D0150 WV 04 00 $40.00 05/17/17
D0220 WV 01 00 $24.00 05/17/17
D0220 WV 04 00 $15.00 05/17/17
D0230 WV 01 00 $23.00 05/17/17
D0230 WV 04 00 $23.00 05/17/17
D0272 WV 01 00 $31.00 05/17/17
D0272 WV 04 00 $31.00 05/17/17
D0274 WV 01 00 $60.00 05/17/17
D0274 WV 04 00 $60.00 05/17/17
D0330 WV 01 00 $90.00 05/17/17
D0330 WV 04 00 $90.00 05/17/17
D0470 WV 01 00 $99.00 05/17/17
D0470 WV 04 00 $99.00 05/17/17
D1110 WV 01 00 $73.00 05/17/17
D1110 WV 04 00 $50.00 05/17/17
D1120 WV 01 00 $40.00 05/17/17
D1120 WV 04 00 $40.00 05/17/17
D1206 WV 01 00 $33.00 05/17/17
D1206 WV 04 00 $33.00 05/17/17
D1208 WV 01 00 $29.00 05/17/17
D1208 WV 04 00 $29.00 05/17/17
D2391 WV 01 00 $135.00 05/17/17
D2391 WV 04 00 $135.00 05/17/17
D7140 WV 01 00 $151.00 05/17/17
D7140 WV 04 00 $90.00 05/17/17
D7210 WV 01 00 $200.00 05/17/17
D7210 WV 04 00 $161.00 05/17/17
D7220 WV 01 00 $245.00 04/20/17
D7220 WV 04 00 $215.00 05/17/17
D7230 WV 01 00 $377.00 04/20/17
D7230 WV 04 00 $191.00 05/17/17
D7240 WV 01 00 $366.00 04/20/17 $335.00 09/23/15
D7240 WV 04 00 $366.00 04/20/17
D7880 WV 01 00 $800.00 05/17/17
D7880 WV 04 00 $800.00 05/17/17
D9220 WV 01 00 $410.00 05/17/17 $398.00 09/24/15
D9220 WV 04 00 $230.00 05/17/17
D9221 WV 01 00 $171.00 05/17/17 $169.00 09/24/15
D9221 WV 04 00 $119.00 05/17/17
D9223 WV 01 00 $225.00 04/20/17
D9223 WV 04 00 $225.00 05/17/17
D9241 WV 01 00 $250.00 05/17/17
D9241 WV 04 00 $250.00 05/17/17
D9242 WV 01 00 $90.00 05/17/17
D9242 WV 04 00 $90.00 05/17/17
E0118 WV 01 RR $50.00 05/17/17
E0118 WV 04 RR $50.00 05/17/17
E0245 WV 01 00 $150.00 05/17/17
E0245 WV 01 NU $150.00 05/17/17
E0245 WV 04 00 $150.00 05/17/17
E0245 WV 04 NU $150.00 05/17/17
E0352 WV 01 00 $45.53 05/17/17
E0352 WV 04 00 $45.53 05/17/17
E0430 WV 01 00 $290.00 05/17/17
E0430 WV 04 00 $290.00 05/17/17
E0440 WV 01 00 $4,500.00 05/17/17
E0440 WV 01 NU $4,500.00 05/17/17
E0440 WV 04 00 $4,500.00 05/17/17
E0440 WV 04 NU $4,500.00 05/17/17
E0445 WV 01 RR $1,282.31 04/20/17
E0445 WV 04 RR $1,282.31 04/20/17
E0455 WV 01 00 $2,750.00 05/17/17
E0455 WV 01 RR $278.25 05/17/17
E0455 WV 04 00 $2,750.00 05/17/17
E0455 WV 04 RR $278.25 05/17/17
E0486 WV 01 00 $2,800.00 05/17/17
E0486 WV 01 NU $2,800.00 05/17/17
E0486 WV 04 00 $2,800.00 05/17/17
E0486 WV 04 NU $2,800.00 05/17/17
E0619 WV 01 RR $776.16 05/17/17
E0619 WV 04 RR $776.16 05/17/17
E1085 WV 01 00 $712.25 05/17/17
E1085 WV 01 NU $712.25 05/17/17
E1085 WV 01 RR $72.00 05/17/17
E1085 WV 04 00 $712.25 05/17/17
E1085 WV 04 NU $712.25 05/17/17
E1085 WV 04 RR $72.00 05/17/17
E1090 WV 01 00 $1,045.00 05/17/17
E1090 WV 01 NU $1,045.00 05/17/17
E1090 WV 01 RR $87.08 05/17/17
E1090 WV 04 00 $1,045.00 05/17/17
E1090 WV 04 NU $1,045.00 05/17/17
E1090 WV 04 RR $87.08 05/17/17
E1130 WV 01 00 $460.00 05/17/17
E1130 WV 01 NU $460.00 05/17/17
E1130 WV 01 RR $48.00 05/17/17
E1130 WV 04 00 $460.00 05/17/17
E1130 WV 04 NU $460.00 05/17/17
E1130 WV 04 RR $48.00 05/17/17
E1140 WV 01 00 $670.00 05/17/17
E1140 WV 01 NU $670.00 05/17/17
E1140 WV 01 RR $174.72 05/17/17
E1140 WV 04 00 $670.00 05/17/17
E1140 WV 04 NU $670.00 05/17/17
E1140 WV 04 RR $174.72 05/17/17
E1250 WV 01 00 $795.00 05/17/17
E1250 WV 01 NU $795.00 05/17/17
E1250 WV 01 RR $232.94 05/17/17
E1250 WV 04 00 $795.00 05/17/17
E1250 WV 04 NU $795.00 05/17/17
E1250 WV 04 RR $232.94 05/17/17
E1260 WV 01 00 $1,250.00 05/17/17
E1260 WV 01 NU $1,250.00 05/17/17
E1260 WV 01 RR $92.10 05/17/17
E1260 WV 04 00 $1,250.00 05/17/17
E1260 WV 04 NU $1,250.00 05/17/17
E1260 WV 04 RR $92.10 05/17/17
E1353 WV 01 RR $140.31 05/17/17
E1353 WV 04 RR $140.31 05/17/17
E2609 WV 01 00 $2,032.00 04/20/17
E2609 WV 04 00 $2,032.00 04/20/17
E2617 WV 01 00 $2,032.00 04/20/17
E2617 WV 04 00 $2,032.00 04/20/17
G0162 WV 01 00 $300.00 05/17/17
G0162 WV 04 00 $300.00 05/17/17
G0177 WV 01 00 $181.63 05/17/17
G0177 WV 04 00 $181.63 05/17/17
G0378 WV 01 00 $70.00 04/20/17
G0378 WV 04 00 $70.00 04/20/17
G0379 WV 01 00 $386.79 04/20/17 $152.60 09/29/15
G0379 WV 04 00 $176.35 05/17/17 $80.00 09/29/15
G0380 WV 01 00 $106.00 05/17/17
G0380 WV 04 00 $106.00 05/17/17
G0381 WV 01 00 $150.00 05/17/17
G0381 WV 04 00 $140.00 05/17/17
G0382 WV 01 00 $199.12 04/20/17
G0382 WV 04 00 $161.00 05/17/17
G0383 WV 01 00 $322.44 04/20/17 $211.50 09/30/15
G0383 WV 04 00 $193.00 05/17/17
G0390 WV 01 00 $1,097.00 05/17/17
G0390 WV 04 00 $1,097.00 05/17/17
G0463 WV 01 00 $135.00 04/20/17
G0463 WV 04 00 $135.00 04/20/17
G0467 WV 01 00 $207.00 04/20/17
G0467 WV 04 00 $207.00 04/20/17
G8539 WV 01 00 $31.25 05/17/17
G8539 WV 04 00 $31.25 05/17/17
G8542 WV 01 00 $31.25 05/17/17
G8542 WV 04 00 $31.25 05/17/17
H0004 WV 01 00 $17.00 05/17/17
H0004 WV 04 00 $17.00 05/17/17
H0015 WV 01 00 $282.00 09/18/17 $268.00 02/24/16
H0015 WV 01 00 $268.00 02/24/16
H0015 WV 04 00 $282.00 09/18/17 $268.00 02/24/16
H0015 WV 04 00 $268.00 02/24/16
H0031 WV 01 00 $120.00 05/17/17
H0031 WV 04 00 $120.00 05/17/17
H0032 WV 01 00 $105.00 03/15/16
H0032 WV 04 00 $105.00 03/15/16
H0035 WV 01 00 $268.00 09/22/15 $254.00 01/03/14
H0035 WV 01 00 $282.00 09/18/17 $268.00 09/22/15
H0035 WV 04 00 $268.00 09/22/15 $254.00 01/03/14
H0035 WV 04 00 $282.00 09/18/17 $268.00 09/22/15
H0037 WV 01 00 $357.00 09/22/15 $339.00 01/03/14
H0037 WV 01 00 $377.00 09/18/17 $357.00 09/22/15
H0037 WV 04 00 $357.00 09/22/15 $339.00 01/03/14
H0037 WV 04 00 $377.00 09/18/17 $357.00 09/22/15
H1003 WV 01 00 $110.00 05/17/17
H1003 WV 04 00 $110.00 05/17/17
H2019 WV 01 00 $18.75 05/17/17
H2019 WV 04 00 $12.50 05/17/17
K0739 WV 01 00 $14.87 12/01/15 $14.55 12/19/13
K0739 WV 01 00 $15.26 01/24/18 $15.02 12/29/16
K0739 WV 04 00 $14.87 12/01/15 $14.55 12/19/13
K0739 WV 04 00 $15.26 01/24/18 $15.02 12/29/16
L3215 WV 01 00 $76.64 03/15/16
L3215 WV 04 00 $76.64 03/15/16
L3216 WV 01 00 $122.00 03/15/16
L3216 WV 04 00 $122.00 03/15/16
L3217 WV 01 00 $95.00 03/15/16
L3217 WV 04 00 $95.00 03/15/16
L3219 WV 01 00 $88.16 03/15/16
L3219 WV 04 00 $88.16 03/15/16
L3221 WV 01 00 $163.80 03/15/16
L3221 WV 04 00 $163.80 03/15/16
L3222 WV 01 00 $115.00 03/15/16
L3222 WV 04 00 $115.00 03/15/16
L3230 WV 01 00 $274.56 03/15/16
L3230 WV 04 00 $274.56 03/15/16
L3250 WV 01 00 $231.77 03/15/16
L3250 WV 04 00 $231.77 03/15/16
L3251 WV 01 00 $288.00 03/15/16
L3251 WV 04 00 $288.00 03/15/16
L3252 WV 01 00 $187.20 03/15/16
L3252 WV 04 00 $187.20 03/15/16
L3253 WV 01 00 $89.00 03/15/16
L3253 WV 04 00 $89.00 03/15/16
L3260 WV 01 00 $65.00 05/17/17
L3260 WV 04 00 $65.00 05/17/17
L3320 WV 01 00 $60.00 05/17/17
L3320 WV 04 00 $60.00 05/17/17
L3485 WV 01 00 $19.00 05/17/17
L3485 WV 04 00 $19.00 05/17/17
L4205 WV 01 00 $22.13 12/01/15 $21.66 12/19/13
L4205 WV 01 00 $22.71 01/24/18 $22.35 12/29/16
L4205 WV 04 00 $22.13 12/01/15 $21.66 12/19/13
L4205 WV 04 00 $22.71 01/24/18 $22.35 12/29/16
L7520 WV 01 00 $30.08 12/01/15 $29.43 12/19/13
L7520 WV 01 00 $30.87 01/24/18 $30.38 12/29/16
L7520 WV 04 00 $30.08 12/01/15 $29.43 12/19/13
L7520 WV 04 00 $30.87 01/24/18 $30.38 12/29/16
L8010 WV 01 00 $43.43 05/17/17
L8010 WV 04 00 $43.43 05/17/17
L8680 WV 01 00 $1,430.00 05/17/17
L8680 WV 04 00 $1,430.00 05/17/17
P9016 WV 01 00 $349.00 05/17/17
P9016 WV 04 00 $349.00 05/17/17
P9035 WV 01 00 $2,606.65 05/17/17
P9035 WV 04 00 $2,606.65 05/17/17
P9037 WV 01 00 $2,424.80 05/17/17
P9037 WV 04 00 $2,424.80 05/17/17
P9040 WV 01 00 $918.15 05/17/17
P9040 WV 04 00 $918.15 05/17/17
P9603 WV 01 00 $1.03 04/20/17
P9603 WV 04 00 $1.01 05/17/17
P9604 WV 01 00 $9.60 05/17/17
P9604 WV 04 00 $9.60 05/17/17
Q0081 WV 01 00 $397.20 05/17/17
Q0081 WV 04 00 $397.20 05/17/17
S9430 WV 01 00 $385.00 04/20/17
S9430 WV 04 00 $300.00 05/17/17
S9480 WV 01 00 $282.00 09/18/17 $268.00 02/24/16
S9480 WV 01 00 $268.00 02/24/16
S9480 WV 04 00 $282.00 09/18/17 $268.00 02/24/16
S9480 WV 04 00 $268.00 02/24/16
V5264 WV 01 00 $79.00 04/20/17
V5264 WV 04 00 $79.00 04/20/17