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South Carolina rates for HCPCS L5301

Below knee (BK), molded socket, shin, SACH foot, endoskeletal system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $1,479.11 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,584.89 / $2,454.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,454.71 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,235.94 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,737.80 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $3,715.35
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,862.09
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $2,454.71 / $5,248.07
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.19 / $2,089.30 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,621.81 / $2,137.96