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Louisiana rates for HCPCS 64901

Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.00 / $1,520.00 / $3,685.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.59 / $888.93 / $987.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,368.21 / $6,927.13 / $9,730.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.10 / $789.41 / $1,081.65
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $499.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$725.00 / $725.00 / $725.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.04 / $800.87 / $1,039.68
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
$514.76 / $718.83 / $1,277.61