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South Carolina rates for HCPCS 21421

Closed Tx Palatal/Maxillary Fx W/Fixation/Splint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.28 / $1,961.15 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.54 / $631.16 / $1,009.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,620.48 / $5,819.33 / $10,022.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.67 / $631.73 / $1,058.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$715.00 / $910.23 / $2,279.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.99 / $876.32 / $1,409.41
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$605.61 / $848.58 / $1,346.29
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,747.48 / $1,747.48 / $1,747.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.06 / $447.35 / $825.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,550.00 / $10,878.00 / $16,772.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.47 / $805.54 / $1,434.77