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Michigan rates for HCPCS 15733

Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,212.17 / $4,112.00 / $5,433.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.14 / $1,119.44 / $1,617.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,922.83 / $6,903.26 / $9,352.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.60 / $1,033.36 / $1,622.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$849.97 / $1,173.44 / $4,023.86
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,067.29 / $1,958.00 / $5,433.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$968.54 / $1,111.79 / $1,567.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.86 / $721.31 / $1,180.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $7,780.00 / $10,556.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.47 / $1,245.01 / $1,879.26