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South Carolina rates for HCPCS Q4176

NeoPatch or Therion, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $154.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $158.49 / $162.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $117.49 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $169.82 / $257.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $158.49 / $165.96