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Louisiana rates for HCPCS 99480

Subsequent Intensive Care Infant 2501-5000 Grams

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.14 / $138.69 / $170.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.65 / $118.30 / $177.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.09 / $126.42 / $213.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.19 / $137.41 / $212.90
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.40 / $100.40 / $107.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.90 / $132.90 / $132.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.97 / $129.01 / $219.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.58 / $130.06 / $189.83