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Louisiana rates for HCPCS 40801

Drg Absc Cst Hmtma Vestibule Mouth Comp

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.00 / $1,299.00 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.72 / $320.38 / $431.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$475.47 / $1,027.53 / $2,357.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.38 / $375.93 / $460.65
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.50 / $309.23 / $512.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.00 / $513.00 / $1,226.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.08 / $419.94 / $591.50