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South Carolina rates for HCPCS 15130

Dermal Autograft Trunk/Arm/Leg 1st 100 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.66 / $4,230.00 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.83 / $644.66 / $926.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,054.52 / $3,883.00 / $6,494.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.91 / $652.94 / $993.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,604.11 / $1,604.11 / $1,604.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$550.72 / $732.27 / $950.45
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.60 / $737.36 / $983.12
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,397.41 / $1,397.41 / $1,397.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $455.50 / $772.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$791.00 / $10,257.00 / $16,249.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.16 / $687.08 / $1,133.68