go back

South Carolina rates for HCPCS L4370

Pneumatic Full Leg Splint Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.27 / $105.27 / $105.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.00 / $105.27 / $186.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.00 / $156.34 / $225.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.73 / $150.11 / $165.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.58 / $147.82 / $150.11
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.65 / $153.00 / $334.03
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $120.00 / $129.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.72 / $143.72 / $143.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.84 / $105.16 / $143.04