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South Carolina rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$797.10 / $2,359.94 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.15 / $851.50 / $1,458.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,709.21 / $5,405.49 / $8,981.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.00 / $709.00 / $1,014.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.00 / $580.00 / $3,200.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.32 / $894.87 / $1,221.26
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$690.81 / $851.97 / $1,252.82
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,872.87 / $2,872.87 / $2,872.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $551.23 / $954.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $12,798.00 / $19,665.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.80 / $844.86 / $1,394.02