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Louisiana rates for HCPCS 64612

Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.98 / $1,093.00 / $3,500.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,190.00 / $1,190.00 / $1,190.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.42 / $174.11 / $222.93
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$225.20 / $225.20 / $225.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.08 / $450.90 / $669.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.38 / $168.41 / $224.76
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $105.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.00 / $425.00 / $425.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.07 / $169.17 / $236.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.00 / $543.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.06 / $161.94 / $293.06