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Louisiana rates for HCPCS 00103

Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$489.78 / $1,819.70 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$524.81 / $562.34 / $933.25
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$489.78 / $489.78 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$218.78 / $223.87 / $457.09