go back

South Carolina rates for HCPCS L5590

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Laminated Socket Molded To Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,290.75 / $1,290.75 / $1,290.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,290.75 / $1,290.75 / $2,147.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,670.00 / $2,105.42 / $3,058.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,285.00 / $2,289.62 / $2,527.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,671.42 / $1,671.42 / $2,240.41
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,283.95 / $2,067.00 / $4,531.35
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,622.00 / $1,622.00 / $1,743.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.07 / $1,439.45 / $2,168.80