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Louisiana rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.00 / $1,850.00 / $3,884.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.12 / $919.77 / $1,233.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,829.62 / $4,819.04 / $7,020.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.40 / $965.46 / $1,144.24
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.76 / $869.35 / $1,289.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $3,238.00 / $8,257.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.46 / $890.95 / $1,605.27