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Louisiana rates for HCPCS V2624

Polishing/resurfacing of ocular prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.17 / $74.70 / $79.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.44 / $58.03 / $59.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.07 / $35.07 / $35.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.30 / $44.21 / $52.29