go back

Louisiana rates for HCPCS 0450T

Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.76 / $1,300.00 / $3,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.99 / $321.23 / $516.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,667.68 / $12,814.83 / $17,698.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$848.00 / $848.00 / $848.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.00 / $513.00 / $1,226.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.70 / $349.06 / $652.89