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South Carolina rates for HCPCS 65290

Repair of wound, extraocular muscle, tendon and/or Tenon's capsule

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $9,120.11 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $602.56 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $5,495.41 / $10,232.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $575.44 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $575.44 / $1,047.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $602.56 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $13,182.57 / $23,988.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $501.19 / $794.33