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South Carolina rates for HCPCS 21261

Periorbital Osteotomies W/Bone Grafts Icra & Xtr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,767.94 / $6,692.22 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,141.91 / $2,520.71 / $2,908.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,717.57 / $9,950.93 / $16,952.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,234.40 / $2,568.36 / $4,432.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $890.00 / $2,718.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,437.89 / $3,097.40 / $5,553.89
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,504.96 / $2,969.00 / $5,428.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.93 / $1,749.17 / $3,235.78
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
$1,976.35 / $2,563.39 / $5,418.85