go back

South Carolina rates for HCPCS L5570

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,084.94 / $1,084.94 / $1,084.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.94 / $1,084.94 / $1,805.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,405.00 / $1,771.33 / $2,570.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,080.09 / $1,769.38 / $1,953.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.65 / $1,458.44 / $1,769.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,079.23 / $1,738.00 / $3,808.84
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,364.00 / $1,364.00 / $1,465.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.36 / $1,209.93 / $1,823.00