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South Carolina rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.90 / $308.02 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.69 / $182.87 / $298.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.17 / $160.36 / $264.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.00 / $143.11 / $218.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.13 / $207.50 / $365.05
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.43 / $197.20 / $331.91
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.53 / $30.53 / $30.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.14 / $187.03 / $285.87
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
$181.78 / $251.21 / $462.66