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South Carolina rates for HCPCS Q4195

Puraply Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.84 / $102.84 / $102.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.37 / $97.94 / $102.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.89 / $161.47 / $252.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $170.83 / $225.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.40 / $97.94 / $97.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.87 / $113.12 / $206.40
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.87 / $75.87 / $75.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.10 / $97.94 / $107.73