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Louisiana rates for HCPCS L4130

Replace pretibial shell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.08 / $373.75 / $503.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.10 / $373.75 / $406.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$567.01 / $968.65 / $1,361.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.67 / $462.52 / $462.52
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.57 / $373.57 / $373.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $326.76 / $373.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.61 / $276.36 / $325.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.90 / $300.48 / $429.70