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South Carolina rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $5,888.44 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $208.93 / $371.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $3,981.07 / $7,079.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $190.55 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $229.09 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $234.42 / $512.86
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $263.03
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $229.09 / $398.11
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $6,309.57 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $199.53 / $323.59