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Louisiana rates for HCPCS A2014

Omeza Collagen Matrix or Omeza Complete Matrix, per 100 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $125.89 / $151.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.89 / $70.79 / $87.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $128.82 / $131.83