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South Carolina rates for HCPCS 42104

Exc Lesion Palate Uvula W/O Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$255.42 / $571.87 / $9,062.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.88 / $209.80 / $374.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,371.90 / $4,283.42 / $6,798.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.16 / $192.48 / $297.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.92 / $242.75 / $570.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.09 / $230.63 / $434.83
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.15 / $227.00 / $383.12
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.00 / $179.03 / $542.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.39 / $223.86 / $348.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$614.00 / $6,607.00 / $10,400.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.71 / $234.95 / $431.60