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South Carolina rates for HCPCS A2014

Omeza Collagen Matrix or Omeza Complete Matrix, per 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $125.89 / $128.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $162.18 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $134.90 / $186.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $54.95 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $128.82 / $128.82