go back

South Carolina rates for HCPCS A9604

Sm 153 Lexidronam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,022.36 / $16,022.36 / $16,022.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,022.36 / $16,022.36 / $16,608.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,951.43 / $31,573.37 / $50,287.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,611.37 / $8,910.86 / $19,867.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $16,282.88 / $16,282.88