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South Carolina rates for HCPCS 21088

Impression & Preparation Facial Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,664.85 / $3,664.85 / $3,664.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$968.92 / $3,219.53 / $3,664.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,577.52 / $10,744.95 / $17,033.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $2,279.96 / $5,181.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$786.09 / $4,698.60 / $8,707.33
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,034.59 / $3,877.45 / $6,421.07
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,747.48 / $1,747.48 / $1,747.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $16,223.00 / $23,485.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,014.53 / $2,972.80 / $6,307.60