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Louisiana rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,949.84 / $4,570.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $6,606.93 / $10,715.19
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $302.00 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $812.83 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,630.27 / $7,943.28