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Michigan rates for HCPCS 19367

Breast Reconstruction Single Pedicled Tram Flap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,087.56 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,462.48 / $2,087.56 / $2,087.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,381.99 / $9,784.31 / $13,328.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.01 / $2,663.20 / $4,194.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,434.12 / $2,221.39 / $3,582.60
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,895.10 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,895.10 / $1,929.98 / $2,752.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.35 / $1,218.95 / $2,062.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,069.00 / $8,847.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,918.77 / $2,230.33 / $2,958.30