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Louisiana rates for HCPCS Q4184

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.04 / $80.84 / $82.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.04 / $80.84 / $88.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.04 / $88.04 / $132.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.04 / $88.04 / $89.80
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.51 / $75.51 / $80.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.04 / $80.04 / $80.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.05 / $80.04 / $97.65