go back

Louisiana rates for HCPCS 21110

Appl Interdental Fixation Device Non-Fx/Dislc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$497.00 / $1,273.00 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.32 / $975.10 / $1,274.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,267.36 / $2,165.67 / $3,102.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.13 / $1,036.99 / $1,325.47
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $652.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.00 / $425.00 / $425.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.66 / $994.41 / $1,407.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $1,689.00 / $4,123.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.40 / $851.35 / $1,447.40