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South Carolina rates for HCPCS 21215

Graft Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.53 / $5,373.19 / $17,247.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.57 / $3,374.21 / $4,591.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,792.31 / $9,578.99 / $16,900.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.30 / $1,414.04 / $4,924.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,130.00 / $1,349.47 / $6,304.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$988.40 / $2,199.60 / $7,180.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.53 / $1,904.24 / $6,961.68
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.14 / $5,495.14 / $5,495.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.30 / $2,770.70 / $5,140.27
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
$3,174.98 / $4,195.05 / $8,980.90