go back

South Carolina rates for HCPCS L0174

Cervical Collar Semi-Rigid Thermoplastic Foam Two Piece With Thoracic Extension Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.58 / $153.18 / $153.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.68 / $153.18 / $270.99
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.16 / $232.11 / $238.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.00 / $226.93 / $328.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.83 / $216.42 / $238.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.99 / $212.38 / $244.45
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.72 / $222.00 / $486.04
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.00 / $174.00 / $187.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.12 / $209.12 / $209.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.66 / $164.30 / $232.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.93 / $154.40 / $208.14