go back

South Carolina rates for HCPCS A6504

Compression burn garment, glove to wrist, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $141.25 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $95.50 / $151.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20