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South Carolina rates for HCPCS L5631

Addition To Lower Extremity Above Knee Or Knee Disarticulation Acrylic Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.92 / $235.92 / $235.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.91 / $235.92 / $392.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.08 / $257.08 / $257.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.00 / $384.53 / $559.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.87 / $329.53 / $363.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $317.13 / $329.53
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.67 / $378.00 / $828.22
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.00 / $297.00 / $319.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.35 / $356.35 / $356.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.15 / $263.08 / $396.41