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South Carolina rates for HCPCS 21245

Rcnstj Mndbl/Maxl Subpriosteal Implant Partial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.03 / $7,799.00 / $17,247.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.26 / $1,098.33 / $1,437.22
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
$916.88 / $1,188.00 / $1,981.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,130.00 / $1,584.46 / $6,904.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.04 / $1,432.74 / $2,456.17
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.03 / $1,443.59 / $2,337.83
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,014.33 / $5,014.33 / $5,014.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.07 / $848.03 / $1,573.62
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
$960.94 / $1,279.21 / $2,712.50