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Louisiana rates for HCPCS 28490

Cltx Fx Grt Toe Phlx/Phlg W/O Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.87 / $1,142.00 / $3,500.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$111.67 / $127.40 / $194.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.07 / $169.87 / $245.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.68 / $397.58 / $556.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.44 / $180.54 / $228.17
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.84 / $224.51 / $224.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.38 / $179.59 / $247.07
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
$122.36 / $161.57 / $279.89