go back

South Carolina rates for HCPCS L3254

Non-Standard Size Or Width (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.05 / $14.05 / $14.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.05 / $14.05 / $14.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $5.15 / $6.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.75 / $10.75 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $10.75 / $10.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.05 / $14.05 / $18.97
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $15.00 / $15.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00