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Michigan rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.41 / $161.79 / $2,056.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.31 / $113.04 / $198.81
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.38 / $85.38 / $85.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.85 / $332.01 / $449.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.47 / $99.14 / $147.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.68 / $135.22 / $287.75
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.98 / $192.78 / $2,056.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.40 / $132.69 / $203.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.26 / $101.32 / $141.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.42 / $1,205.00 / $2,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.52 / $149.12 / $244.27