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South Carolina rates for HCPCS L5643

Addition To Lower Extremity Hip Disarticulation Flexible Inner Socket External Frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$835.70 / $835.70 / $835.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.96 / $835.70 / $1,390.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,085.00 / $1,367.90 / $1,980.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.01 / $1,167.30 / $1,288.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $1,123.40 / $1,167.30
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.30 / $1,339.00 / $2,933.85
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.00 / $1,050.00 / $1,129.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.53 / $931.98 / $1,404.20