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South Carolina rates for HCPCS 21387

Open Tx Orbital Floor Blowout Fx Combined Appr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$874.40 / $8,324.40 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.21 / $799.16 / $1,056.57
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
$708.09 / $874.00 / $1,536.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.00 / $863.37 / $890.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.22 / $1,030.89 / $1,955.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$827.93 / $1,005.00 / $1,724.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.30 / $549.85 / $1,008.39
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
$631.92 / $823.18 / $1,718.12