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Louisiana rates for HCPCS 64804

Sympathectomy Cervicothoracic

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
$1,052.83 / $1,785.10 / $1,959.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,811.51 / $3,313.02 / $6,038.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,225.99 / $1,645.84 / $2,022.46
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $1,160.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,056.60 / $1,462.97 / $2,124.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $1,791.00 / $4,282.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$935.75 / $1,232.82 / $2,353.71