go back

South Carolina rates for HCPCS A4623

Tracheostomy Inner Cannula. (Rvsd 1/1/04) Ecial Coverage Instructions Apply. See Cim: 65-16)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.22 / $6.22 / $6.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $6.22 / $6.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $3.54 / $3.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.82 / $6.30 / $8.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $5.50 / $6.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $5.50 / $6.62
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.12 / $6.68 / $10.57
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $5.00 / $5.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $4.37 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $3.88 / $5.01