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South Carolina rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,387.92 / $3,085.54 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.83 / $1,223.94 / $1,387.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,085.44 / $4,452.39 / $7,418.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,108.01 / $1,413.00 / $2,342.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.00 / $890.00 / $1,366.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,036.43 / $1,409.29 / $2,640.43
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,052.00 / $1,387.92 / $2,646.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.44 / $1,066.27 / $1,827.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$729.00 / $6,679.00 / $9,900.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$897.75 / $1,203.21 / $2,753.60