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Michigan rates for HCPCS 19380

Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.18 / $5,425.50 / $23,353.17
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,121.37 / $6,371.26 / $9,101.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,694.95 / $7,815.03 / $10,646.21
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,612.58 / $4,929.37 / $6,843.73
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.18 / $5,757.00 / $23,353.17
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,168.58 / $5,472.24 / $9,101.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,069.00 / $8,847.00 / $10,652.00