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Louisiana rates for HCPCS 15136

Dermal Agrft F/S/N/H/F/G/M/D Gt Ea 100 Cm/Ea

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.49 / $1,230.00 / $3,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.62 / $106.97 / $128.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,795.15 / $4,058.90 / $5,701.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.23 / $105.91 / $125.54
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.01 / $103.93 / $151.91
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
$81.53 / $99.97 / $165.01