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South Carolina rates for HCPCS L4030

Replace Quadrilateral Socket Brim, Custom Fitted

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.52 / $281.52 / $281.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.52 / $281.52 / $498.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.00 / $416.04 / $602.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.33 / $477.88 / $527.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.04 / $348.85 / $467.61
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.11 / $408.00 / $893.29
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.00 / $320.00 / $344.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.16 / $281.23 / $382.54