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Louisiana rates for HCPCS V2623

Prosthetic eye, plastic, custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,027.21 / $1,194.43 / $1,194.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.43 / $1,194.43 / $1,194.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,250.33 / $2,136.00 / $3,002.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.39 / $890.64 / $890.64
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.14 / $517.14 / $1,312.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.33 / $631.28 / $949.40