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Michigan rates for HCPCS 19370

Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $4,897.79 / $25,118.86
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$891.25 / $6,309.57 / $8,317.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $630.96 / $1,023.29
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $2,089.30 / $6,918.31
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$891.25 / $6,309.57 / $8,317.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $6,456.54 / $10,471.29