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South Carolina rates for HCPCS 21100

Appl Halo Appliance Maxillofacial Fixation Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.63 / $4,230.00 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.23 / $574.04 / $1,068.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,566.14 / $9,950.93 / $16,952.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.00 / $410.20 / $989.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.00 / $609.29 / $4,769.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.03 / $744.98 / $1,231.52
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.13 / $687.67 / $1,291.71
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,851.65 / $3,851.65 / $3,851.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.68 / $415.71 / $792.28
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
$541.49 / $765.08 / $1,376.52