go back

South Carolina rates for HCPCS L5828

Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,862.09 / $2,818.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,570.40 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,388.44 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,137.96 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $4,168.69
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,089.30 / $2,344.23
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,630.27 / $5,888.44
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,511.89 / $4,570.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,698.24 / $2,570.40