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South Carolina rates for HCPCS L5979

All lower extremity prostheses, multiaxial ankle, dynamic response foot, one-piece system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,479.11 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,754.23 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,698.24 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $3,467.37
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,698.24 / $1,862.09
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $2,137.96 / $4,466.84
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,380.38 / $2,041.74