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Louisiana rates for HCPCS Q4154

Biovance, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.90 / $133.22 / $135.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $133.22 / $145.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.03 / $277.44 / $323.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.03 / $147.03 / $149.97
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.43 / $124.43 / $131.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $131.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.33 / $131.90 / $160.91