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Louisiana rates for HCPCS 64804

Sympathectomy, cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $2,691.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,230.27 / $2,137.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $3,311.31 / $6,025.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,659.59 / $2,041.74
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,412.54 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $1,479.11 / $4,265.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,230.27 / $2,290.87