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South Carolina rates for HCPCS Q4117

Hyalomatrix Per Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.53 / $23.53 / $23.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.28 / $23.53 / $23.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.42 / $16.55 / $20.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.94 / $23.53 / $33.69
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.63 / $14.63 / $14.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.39 / $28.69 / $31.56