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South Carolina rates for HCPCS L4000

Replace Girdle For Spinal Orthotic (Cervic-Thoracic-Lumbar-Sacor

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$727.41 / $727.41 / $727.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.94 / $727.41 / $1,286.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$850.00 / $1,071.63 / $1,557.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$654.57 / $897.58 / $991.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.23 / $655.23 / $1,007.79
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$654.00 / $1,053.00 / $2,308.12
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.00 / $826.00 / $888.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.11 / $993.11 / $993.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.80 / $716.96 / $982.00