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South Carolina rates for HCPCS Q4257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,288.25 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $954.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $165.96 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $912.01 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $954.99 / $1,819.70
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 / $489.78 / $1,659.59