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Louisiana rates for HCPCS 0100T

Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $3,388.44 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,905.46 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $158,489.32 / $346,736.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $18,620.87 / $45,708.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,041.74 / $3,467.37