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South Carolina rates for HCPCS Q4165

Keramatrix Or Kerasorb Per Square Centimeter (Desc Rvsd 10/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.66 / $43.66 / $43.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.58 / $43.66 / $44.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.66 / $35.97 / $43.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.31 / $44.19 / $64.70
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.31 / $12.31 / $12.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.50 / $29.50 / $36.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $44.36 / $48.80