go back

South Carolina rates for HCPCS L5628

Addition To Lower Extremity Test Socket Hemipelvectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$273.73 / $273.73 / $273.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.39 / $273.73 / $455.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.00 / $447.56 / $648.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.83 / $499.82 / $551.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.87 / $367.97 / $499.82
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.29 / $439.00 / $960.98
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.00 / $344.00 / $370.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $435.59 / $457.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.96 / $302.54 / $435.59