go back

South Carolina rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,280.28 / $2,280.28 / $2,280.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,280.28 / $2,280.28 / $3,793.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,950.00 / $3,719.17 / $5,403.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,270.19 / $3,578.08 / $3,950.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $2,612.00 / $3,501.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,268.26 / $3,652.00 / $8,005.26
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,866.00 / $2,866.00 / $3,080.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,444.40 / $3,444.40 / $3,444.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,940.67 / $2,520.29 / $3,632.67