go back

Louisiana rates for HCPCS Q4254

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.88 / $359.43 / $366.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $359.43 / $384.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.00 / $432.00 / $648.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.00 / $432.00 / $440.64
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.00 / $48.00 / $48.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.08 / $480.00 / $585.60