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South Carolina rates for HCPCS A5113

Leg Strap; Latex Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.27 / $5.27 / $5.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $5.27 / $5.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.08 / $6.26 / $7.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.14 / $3.96 / $3.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $3.96 / $4.88
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.29 / $5.90 / $8.48
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $3.09 / $3.95