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Louisiana rates for HCPCS Q4132

Grafix Core and GrafixPL Core, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $107.15 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $128.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $107.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.72 / $39.81 / $478.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $125.89 / $467.74