go back

South Carolina rates for HCPCS L1950

Ankle Foot Orthosis Spiral (Institute Of Rehabilitative Medicine Type) Plastic Custom-Fabricated. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.33 / $415.33 / $415.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.33 / $415.33 / $734.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.00 / $612.71 / $889.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.73 / $524.34 / $578.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.77 / $504.62 / $524.34
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.41 / $602.00 / $1,317.87
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.00 / $472.00 / $507.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.03 / $567.03 / $567.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.77 / $414.90 / $531.16