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Louisiana rates for HCPCS 76642

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.81 / $216.72 / $429.00
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$37.07 / $41.95 / $54.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.33 / $96.60 / $162.40
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.92 / $39.92 / $60.05
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$53.40 / $625.50 / $727.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$44.41 / $56.68 / $90.70
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.50 / $63.89 / $78.61
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.96 / $30.39 / $60.15
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$168.35 / $168.35 / $168.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.70 / $126.24 / $182.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.09 / $104.81 / $157.93
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.54 / $49.09 / $62.36
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$53.54 / $60.15 / $96.79
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.07 / $74.42 / $81.99
Christus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$29.64 / $33.15 / $33.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.67 / $146.50 / $238.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.98 / $85.61 / $152.22
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.21 / $33.15 / $61.89
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$29.77 / $49.56 / $89.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.03 / $182.03 / $182.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.48 / $89.14 / $149.47
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.61 / $34.95 / $56.93
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.97 / $51.77 / $94.36