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South Carolina rates for HCPCS C9091

Injection, sirolimus protein-bound particles, 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.76 / $66.76 / $66.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.76 / $66.76 / $69.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00