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South Carolina rates for HCPCS 21142

Rcnstj Midface Lefort I 2 Pieces W/O Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,570.54 / $11,269.00 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,198.75 / $1,407.66 / $1,868.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,574.01 / $6,711.60 / $13,864.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,315.31 / $1,777.65 / $4,126.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $890.00 / $1,531.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,457.00 / $1,852.25 / $3,035.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,503.00 / $1,808.57 / $3,093.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.60 / $976.77 / $1,802.57
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
$1,141.30 / $1,525.31 / $3,033.24