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Michigan rates for HCPCS 01922

Anes Non-Invasive Imaging/Radiation Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $420.00 / $553.76
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$805.80 / $984.00 / $1,799.20
Aetna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$471.90 / $683.06 / $858.99
Aetna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$400.95 / $609.84 / $827.64
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$202.50 / $233.97 / $459.43
Ambetter
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$101.25 / $150.44 / $190.57
Ambetter
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$119.64 / $132.94 / $164.53
Ambetter
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$222.75 / $334.13 / $334.13
BCBS
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$137.06 / $267.75 / $355.95
BCBS
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$258.86 / $505.75 / $672.35
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482.16 / $791.84 / $791.84
Cigna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$240.00 / $240.00 / $623.26
Cigna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$240.00 / $240.00 / $623.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.81 / $416.00 / $553.76
Health Alliance Plan
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$805.80 / $984.00 / $1,627.56
Health Alliance Plan
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$471.90 / $683.06 / $858.99
Health Alliance Plan
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$400.95 / $609.84 / $827.64