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South Carolina rates for HCPCS C2622

Prosthesis, Penile, Non-Inf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.60 / $1,926.60 / $1,926.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $5,088.08
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00