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South Carolina rates for HCPCS L4010

Replace Trilateral Socket Brim

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$409.34 / $409.34 / $409.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.76 / $409.34 / $724.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $590.74 / $876.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.34 / $626.01 / $691.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.99 / $497.35 / $626.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.03 / $593.00 / $1,298.85
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.00 / $465.00 / $500.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.86 / $558.86 / $558.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.07 / $392.63 / $508.50