go back

Louisiana rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$593.00 / $1,398.45 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.75 / $808.63 / $1,055.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,330.58 / $2,754.68 / $4,536.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$689.71 / $854.47 / $1,147.58
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $543.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$725.00 / $725.00 / $725.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.95 / $868.67 / $1,219.14
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
$550.32 / $770.44 / $1,328.76