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Louisiana rates for HCPCS 21246

Reconstruction of mandible or maxilla, subperiosteal implant; complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.00 / $2,758.00 / $5,432.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$781.57 / $1,094.91 / $1,479.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,783.10 / $8,674.20 / $11,969.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.91 / $1,083.42 / $1,500.76
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $751.10
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
$813.85 / $1,123.94 / $1,603.04
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
$757.09 / $979.76 / $1,644.78