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Louisiana rates for HCPCS A6025

Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.73 / $13.21 / $14.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.27 / $13.21 / $14.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.33 / $12.92 / $13.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.47 / $13.47 / $13.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.07 / $9.34 / $17.20