go back

South Carolina rates for HCPCS L5624

Addition To Lower Extremity Test Socket Above Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.21 / $195.21 / $195.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.21 / $195.21 / $324.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.73 / $212.73 / $212.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.00 / $321.48 / $462.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.30 / $311.77 / $344.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $262.39 / $311.77
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.17 / $313.00 / $685.29
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.00 / $245.00 / $264.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.85 / $294.85 / $294.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.13 / $217.69 / $328.00