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South Carolina rates for HCPCS L1830

Knee orthosis (KO), immobilizer, canvas longitudinal, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $44.67 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $52.48 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $74.13 / $91.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $63.10 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $100.00 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $67.61 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $79.43
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $63.10 / $69.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $77.62 / $162.18
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $83.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $61.66 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $58.88 / $75.86