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Louisiana rates for HCPCS Q4158

Kerecis Omega3, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.27 / $67.95 / $69.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.95 / $74.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.98 / $69.98 / $104.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.98 / $69.98 / $71.38
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.47 / $63.47 / $67.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $67.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.92 / $67.27 / $90.53