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Louisiana rates for HCPCS 21215

Graft Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.00 / $3,200.00 / $6,144.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$801.78 / $3,404.26 / $6,175.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,681.72 / $8,437.98 / $11,892.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.50 / $1,749.98 / $6,360.12
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $705.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,650.00 / $1,650.00 / $1,650.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.24 / $2,155.81 / $6,478.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,141.00 / $4,717.00 / $11,696.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,658.68 / $4,282.79 / $7,795.02