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Michigan rates for HCPCS 21076

Impression&Preparation Surg Obturator Prosthes

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.97 / $938.74 / $1,134.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.20 / $903.97 / $1,134.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.86 / $182.86 / $215.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.17 / $705.88 / $1,215.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.03 / $1,027.53 / $1,566.46
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.97 / $983.95 / $1,092.58
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.19 / $983.95 / $1,417.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.66 / $757.55 / $1,115.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $3,640.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.92 / $1,138.08 / $1,608.88