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Michigan rates for HCPCS 21110

Appl Interdental Fixation Device Non-Fx/Dislc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.76 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$651.11 / $891.76 / $1,110.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$956.70 / $1,122.88 / $1,521.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.47 / $733.92 / $1,214.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.76 / $864.56 / $1,590.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$777.76 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.76 / $894.42 / $1,387.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.24 / $550.47 / $962.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,033.09 / $3,523.00 / $6,036.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$723.65 / $931.36 / $1,293.52