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South Carolina rates for HCPCS 54390

Plastic Rpr Penis Epispadias W/Exstrophy Bladder

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,594.41 / $3,417.62 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.31 / $1,594.41 / $1,938.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,723.04 / $23,723.04 / $23,723.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,153.23 / $1,828.00 / $3,214.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,337.89 / $1,713.16 / $3,233.77
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,255.57 / $1,651.68 / $2,739.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.60 / $1,124.13 / $1,844.65
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
$1,164.75 / $1,681.80 / $3,030.64