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Louisiana rates for HCPCS 41250

Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $1,513.56 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $288.40 / $588.84
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $162.18 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $645.65 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $512.86 / $1,230.27