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South Carolina rates for HCPCS L5647

Addition to lower extremity, below knee (BK), suction socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $512.86 / $794.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $741.31 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $954.99 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $602.56 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $436.52 / $1,096.48
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $575.44 / $630.96
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $724.44 / $1,659.59
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $645.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $707.95 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $478.63 / $724.44