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South Carolina rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $8,709.64 / $16,595.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $5,248.07 / $10,232.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $588.84 / $3,801.89
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $630.96
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $524.81 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $10,232.93 / $17,378.01