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Louisiana rates for HCPCS 40701

Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $3,388.44 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,412.54 / $2,290.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $8,709.64 / $12,302.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,584.89 / $1,905.46
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,380.38 / $2,089.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,248.07 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,318.26 / $2,041.74