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Louisiana rates for HCPCS 25455

Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.00 / $1,850.00 / $3,945.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.02 / $940.15 / $1,270.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,739.66 / $5,937.24 / $10,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.76 / $954.79 / $1,187.08
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $672.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $1,200.00 / $1,200.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.25 / $1,016.51 / $1,355.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.00 / $5,493.00 / $15,885.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.50 / $830.01 / $1,507.46