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Louisiana rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $2,500.00 / $4,050.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.53 / $1,387.01 / $1,535.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,015.83 / $1,246.68 / $1,576.64
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $849.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.38 / $1,242.20 / $1,643.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,309.00 / $6,699.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.94 / $1,064.71 / $1,987.07