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South Carolina rates for HCPCS 21268

Orbital Repositioning W/Bone Grafts Icra & Xtrc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,291.01 / $9,062.00 / $18,276.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,768.38 / $2,090.71 / $2,410.02
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
$1,849.26 / $2,116.38 / $3,602.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $890.00 / $2,252.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,018.16 / $2,561.65 / $5,269.33
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.01 / $2,415.00 / $4,492.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.90 / $1,444.58 / $2,676.23
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
$1,672.75 / $2,133.94 / $4,490.12