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Michigan rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $794.33 / $1,380.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $1,659.59 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $891.25 / $3,467.37
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $4,073.80 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $954.99 / $1,258.93
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $812.83 / $3,090.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,888.44 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $912.01 / $1,202.26