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Louisiana rates for HCPCS 43622

Gstrct Tot W/Frmj Intstinal Pouch Any Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $3,212.00 / $3,884.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,098.44 / $3,357.77 / $3,844.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,640.84 / $3,355.42 / $4,069.04
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $2,081.14 / $2,081.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.00 / $675.00 / $2,631.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,129.13 / $3,130.69 / $5,053.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,261.00 / $7,168.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,022.82 / $2,802.68 / $4,874.26