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Michigan rates for HCPCS 15760

Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$817.82 / $984.15 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.52 / $817.82 / $1,061.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,412.60 / $2,811.98 / $3,809.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.79 / $1,360.26 / $1,688.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.75 / $793.30 / $2,936.46
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.54 / $1,001.86 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.63 / $867.44 / $1,193.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.25 / $591.87 / $934.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,527.00 / $3,640.00 / $6,740.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$815.08 / $965.70 / $1,269.24