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South Carolina rates for HCPCS L1290

Addi To Thoracic-Lumbar-Sacral Orthotic (Tlso), (Low Profile), L

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.72 / $55.72 / $55.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.59 / $55.72 / $98.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.32 / $101.32 / $101.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $83.20 / $119.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.13 / $60.55 / $66.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.20 / $60.55 / $67.70
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.57 / $81.00 / $176.80
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.00 / $63.00 / $68.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.07 / $76.07 / $76.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.06 / $118.06 / $118.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.82 / $50.71 / $66.54