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South Carolina rates for HCPCS L1690

Combination Bilateral Lumbo-Sacral Hip Femur Orthosis Providing Adduction And Internal Rotation Control Prefabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,159.43 / $1,159.43 / $1,159.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.90 / $1,159.43 / $2,051.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,452.00 / $1,802.98 / $2,575.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.87 / $1,300.55 / $1,435.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$949.40 / $949.40 / $1,474.81
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,042.42 / $1,678.00 / $3,678.96
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,310.00 / $1,310.00 / $1,415.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,582.92 / $1,582.92 / $1,582.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.11 / $1,116.56 / $1,408.70