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Louisiana rates for HCPCS Q4180

Revita Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.12 / $662.69 / $675.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $662.69 / $721.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.65 / $120.45 / $1,133.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.15 / $1,133.15 / $1,155.81
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.98 / $618.98 / $656.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $656.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.41 / $656.12 / $820.15