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South Carolina rates for HCPCS A6258

Transparent Film More Than 16 Sq. In. But Less Than Or Equal To 48 Sq. In. Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $4.80 / $4.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.81 / $4.80 / $5.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.02 / $6.26 / $11.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.93 / $2.93 / $7.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.20 / $5.29 / $10.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,000.00 / $3,000.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.87 / $3.62