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South Carolina rates for HCPCS 21485

Closed Tx Temporomandibular Dislc Comp 1st/Sbsq

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.93 / $4,230.00 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$695.10 / $895.93 / $1,094.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,771.58 / $4,097.39 / $6,979.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.00 / $695.25 / $981.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.00 / $780.00 / $1,243.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$544.51 / $930.04 / $1,995.31
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.58 / $914.09 / $1,696.02
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$829.05 / $829.05 / $829.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.36 / $643.50 / $1,203.20
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
$665.95 / $825.89 / $1,749.90