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Michigan rates for HCPCS 19364

Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,212.55 / $4,933.00 / $5,757.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,018.27 / $15,173.25 / $20,557.34
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$8,719.64 / $10,278.67 / $13,405.18
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,921.50 / $4,933.00 / $5,757.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,080.11 / $7,519.00 / $10,351.00