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South Carolina rates for HCPCS 40702

Plstc Rpr Cl Lip/Nsl Dfrm Prim Bi 1 2 Stgs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,178.85 / $8,783.00 / $16,639.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$780.92 / $1,178.85 / $1,558.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,520.31 / $10,744.95 / $17,033.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.44 / $1,147.00 / $1,543.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.93 / $4,769.93 / $4,769.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.32 / $1,134.29 / $1,522.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.74 / $1,142.00 / $1,585.07
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,851.65 / $3,851.65 / $3,851.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.14 / $834.32 / $1,169.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $16,959.00 / $23,485.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.76 / $973.06 / $1,702.86