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South Carolina rates for HCPCS L5000

Partial Foot Shoe Insert With Longitudinal Arch Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.16 / $284.16 / $284.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.61 / $284.16 / $472.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.64 / $476.40 / $635.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.00 / $466.48 / $673.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.89 / $459.90 / $507.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $437.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.66 / $455.00 / $997.57
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.00 / $357.00 / $384.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.22 / $429.22 / $429.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.26 / $314.06 / $455.84