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South Carolina rates for HCPCS 20902

Bone Graft Any Donor Area Major/Large

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,034.89 / $6,305.60 / $11,018.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.50 / $6,861.51 / $12,212.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.69 / $715.00 / $5,740.31
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$30.65 / $30.65 / $30.65
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.77 / $521.13 / $847.00
Medcost
Facility/Professional
Facility
Modifier
80
Low / Median / High Price
$78.69 / $128.78 / $172.06
Medcost
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$51.44 / $84.83 / $120.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $12,456.00 / $19,591.00