go back

Louisiana rates for HCPCS J2504

Injection, pegademase bovine, 25 IU

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.56 / $416.56 / $583.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.56 / $416.56 / $416.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.13 / $172.63 / $374.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.90 / $374.90 / $382.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.96 / $367.96 / $367.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.54 / $357.54 / $481.17