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South Carolina rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $436.52 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $776.25 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $575.44 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $1,023.29
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $501.19 / $562.34
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $602.56 / $1,258.93
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $251.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $512.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $575.44 / $1,047.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $380.19 / $575.44