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South Carolina rates for HCPCS A5114

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.50 / $8.50 / $8.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.56 / $8.50 / $9.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.59 / $8.61 / $12.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.63 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $6.38 / $8.58
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.32 / $9.00 / $16.70
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $7.00 / $7.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.18 / $7.18 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.57 / $5.26 / $6.84