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Louisiana rates for HCPCS 27197

Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$297.00 / $1,300.00 / $3,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $157.65 / $220.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.86 / $487.67 / $930.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $172.04 / $213.49
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.48 / $97.48 / $97.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.76 / $174.41 / $234.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.00 / $543.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.90 / $139.44 / $262.26