go back

South Carolina rates for HCPCS L4210

Repair Of Orthotic Device Repair Or Replace Minor Parts (Special Coverage Instructions Apply. See Mcm: 2133 2100.4 2130d)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $15.45 / $19.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.25 / $56.25 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.89 / $117.89 / $117.89
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.00 / $20.00 / $27.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.34 / $35.34 / $35.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.87 / $10.87 / $30.00