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South Carolina rates for HCPCS L5020

Partial Foot Molded Socket Tibial Tubercle Height With Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,165.49 / $1,165.49 / $1,165.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,085.30 / $1,165.49 / $1,939.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,510.00 / $1,903.71 / $2,761.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,160.30 / $1,486.28 / $1,640.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.98 / $1,486.28 / $1,566.73
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,159.34 / $1,867.00 / $4,091.60
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,465.00 / $1,465.00 / $1,574.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,760.49 / $1,760.49 / $1,760.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428.89 / $1,428.89 / $1,428.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$875.17 / $1,288.16 / $1,787.92