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South Carolina rates for HCPCS L2624

Addition To Lower Extremity Pelvic Control Hip Joint Adjustable Flexion Extension Abduction Control Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.46 / $232.46 / $232.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.91 / $232.46 / $411.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.00 / $346.70 / $497.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.18 / $291.02 / $321.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.45 / $282.44 / $291.02
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.46 / $337.00 / $737.62
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.00 / $264.00 / $284.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.37 / $317.37 / $317.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.16 / $211.05 / $280.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.10 / $217.13 / $280.42