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South Carolina rates for HCPCS L5962

Addition Endoskeletal System Below Knee Flexible Protective Outer Surface Covering System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.66 / $340.66 / $340.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.22 / $340.66 / $566.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.17 / $514.17 / $514.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.00 / $561.03 / $807.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$339.14 / $448.56 / $495.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.45 / $448.56 / $457.92
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.86 / $546.00 / $1,195.92
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.00 / $428.00 / $460.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.55 / $514.55 / $514.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.15 / $470.15 / $470.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.92 / $376.51 / $530.29