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Louisiana rates for HCPCS 49904

Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $2,562.00 / $3,884.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $1,257.63 / $1,257.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.00 / $675.00 / $1,577.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,261.00 / $7,168.00