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South Carolina rates for HCPCS 21386

Open Tx Orbital Floor Blowout Fx Periorbital

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.96 / $5,373.20 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.82 / $722.68 / $1,754.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,717.57 / $10,098.54 / $16,900.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.45 / $933.00 / $1,549.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$783.40 / $815.00 / $890.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$760.49 / $941.00 / $1,707.84
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$778.57 / $949.15 / $1,527.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.30 / $517.38 / $952.88
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
$537.83 / $736.55 / $1,556.98