go back

South Carolina rates for HCPCS L5622

Addition To Lower Extremity Test Socket Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.65 / $194.65 / $194.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.65 / $194.65 / $323.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.00 / $321.48 / $461.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.37 / $274.54 / $303.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.41 / $200.41 / $305.19
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.63 / $312.00 / $683.35
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.00 / $245.00 / $263.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.02 / $294.02 / $294.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.16 / $217.07 / $327.07