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Louisiana rates for HCPCS J1096

Dexamethasone Lacrimal Ophthalmic Insert 0.1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.49 / $106.56 / $253.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.49 / $103.96 / $122.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.12 / $121.75 / $147.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.75 / $121.75 / $124.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.11 / $97.11 / $102.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $102.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.93 / $102.93 / $102.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.94 / $102.94 / $175.52