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South Carolina rates for HCPCS 21155

Rcnstj Midface Lefort Iii W/Lefort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,485.38 / $9,062.00 / $18,276.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,947.20 / $2,209.98 / $2,988.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,883.03 / $8,787.67 / $13,996.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,994.64 / $3,081.00 / $4,958.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $890.00 / $2,447.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,512.26 / $2,998.90 / $5,212.12
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,383.90 / $2,993.00 / $4,776.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.98 / $1,552.40 / $2,842.18
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
$1,795.82 / $2,514.14 / $4,829.70