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Michigan rates for HCPCS 12017

Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.24 / $2,877.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.42 / $185.24 / $219.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.37 / $372.23 / $504.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.94 / $150.34 / $254.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.15 / $206.07 / $564.91
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.85 / $2,877.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.32 / $177.37 / $244.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.75 / $171.82 / $239.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.00 / $1,418.00 / $2,449.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.80 / $194.02 / $347.76