go back

South Carolina rates for HCPCS L5795

Addition Exoskeletal System Hip Disarticulation Ultra-Light Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$768.66 / $768.66 / $768.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.35 / $768.66 / $1,278.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.00 / $1,254.44 / $1,821.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.27 / $908.11 / $1,002.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $1,033.28
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.65 / $1,231.00 / $2,410.10
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$966.00 / $966.00 / $1,038.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,718.25 / $1,718.25 / $1,718.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.76 / $849.57 / $1,033.02