go back

Louisiana rates for HCPCS 15769

Grafting Of Autologous Soft Tiss By Direct Exc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.97 / $2,472.00 / $4,392.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.22 / $522.97 / $765.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,663.56 / $6,828.12 / $13,858.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.33 / $541.79 / $692.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.43 / $546.54 / $800.83
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
$403.47 / $500.20 / $997.80