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South Carolina rates for HCPCS 96004

Phys/Qhp R&I Cptr Mtn Alys Walk/Funcjl Actv Repr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.89 / $111.89 / $111.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.36 / $108.70 / $116.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.83 / $99.64 / $142.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.06 / $141.28 / $217.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.58 / $136.00 / $225.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.09 / $113.27 / $169.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.93 / $117.54 / $179.41