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Louisiana rates for HCPCS 99475

Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$544.19 / $661.12 / $811.10
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.24 / $470.24 / $521.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.70 / $635.70 / $635.70