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Louisiana rates for HCPCS 12004

Simple Rpr Scalp/Neck/Ax/Genit/Trunk 7.6-12.5cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.47 / $900.00 / $3,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.50 / $109.40 / $168.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.10 / $352.53 / $511.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.02 / $136.46 / $161.69
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.14 / $69.14 / $69.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $116.51 / $210.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.00 / $473.90 / $1,200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.76 / $135.34 / $235.15