go back

Louisiana rates for HCPCS 21100

Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,513.56 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $588.84 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $8,709.64 / $12,022.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $645.65 / $954.99
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $630.96 / $1,096.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,248.07 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $602.56 / $1,047.13