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South Carolina rates for HCPCS 31623

Brnchsc Brushing/Protected Brushings

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.04 / $2,481.26 / $7,796.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.01 / $273.24 / $471.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.89 / $84.89 / $182.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.00 / $2,138.92 / $4,021.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.27 / $298.55 / $529.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,007.90 / $1,007.90 / $1,295.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.12 / $277.56 / $546.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.78 / $326.04 / $513.74
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.90 / $891.75 / $1,036.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.54 / $299.85 / $467.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.00 / $6,607.00 / $8,667.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.32 / $439.87 / $710.23