go back

South Carolina rates for HCPCS 21401

Closed Tx Fx Orbit Except Blowout W/Manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$374.86 / $1,375.36 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.14 / $451.60 / $636.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,942.30 / $4,057.00 / $6,811.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.00 / $370.32 / $578.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$557.65 / $580.00 / $1,074.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.50 / $524.87 / $1,009.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.24 / $538.74 / $933.28
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,081.31 / $1,081.31 / $1,081.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.68 / $378.10 / $698.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$729.00 / $6,607.00 / $8,667.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.72 / $532.55 / $1,142.50