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South Carolina rates for HCPCS L6675

Upper Extremity Addition Harness (E.G. Figure Of Eight Type) Single Cable Design. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.48 / $64.48 / $64.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.48 / $64.48 / $107.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $107.16 / $152.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.20 / $90.07 / $99.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.75 / $86.68 / $90.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.14 / $104.00 / $226.38
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.00 / $81.00 / $87.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.39 / $97.39 / $97.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.30 / $71.91 / $108.35