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Michigan rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,642.48 / $1,705.65 / $2,070.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.01 / $1,642.48 / $2,070.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.43 / $388.43 / $1,213.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.16 / $1,553.70 / $2,233.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,155.58 / $1,886.14 / $2,839.48
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,642.48 / $1,812.33 / $1,993.64
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,562.90 / $1,812.33 / $2,585.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.00 / $1,085.21 / $1,820.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,500.00 / $8,702.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,719.67 / $2,108.21 / $2,950.54