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South Carolina rates for HCPCS 21089

Unlisted Maxillofacial Prosthetic Procedure

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.47 / $294.10 / $462.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $890.00 / $890.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $120.00 / $2,117.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.00 / $1,221.00 / $3,585.00