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Louisiana rates for HCPCS 42205

Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$816.00 / $2,418.00 / $4,392.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.69 / $1,368.41 / $1,559.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,140.92 / $5,301.99 / $10,545.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.81 / $1,321.32 / $1,673.72
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $846.60 / $1,342.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$725.00 / $1,084.92 / $1,932.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$847.24 / $1,252.26 / $1,921.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,100.00 / $4,717.00 / $10,959.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.98 / $1,157.21 / $1,999.22