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South Carolina rates for HCPCS 99478

Subsequent Intensive Care Infant < 1500 Grams

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.17 / $122.43 / $199.07
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.16 / $132.16 / $132.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.00 / $122.02 / $195.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $152.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.24 / $159.38 / $260.23
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.08 / $171.15 / $250.85
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.15 / $171.15 / $800.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.92 / $151.88 / $235.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.24 / $138.11 / $213.49