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South Carolina rates for HCPCS Q4157

Revitalon Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.84 / $171.84 / $171.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.65 / $171.84 / $178.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.01 / $137.72 / $167.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.13 / $178.13 / $178.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.13 / $178.13 / $178.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.84 / $199.08 / $288.69
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.08 / $199.08 / $199.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.74 / $157.74 / $165.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.67 / $202.90 / $223.19