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Michigan rates for HCPCS 21138

Rdctj Fhd Cntrg & Prosthetic Matrl/Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,166.56 / $4,112.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.85 / $1,166.56 / $1,211.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.39 / $5,597.88 / $7,584.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.01 / $820.80 / $1,537.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.35 / $1,029.24 / $1,948.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$907.14 / $4,112.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$907.14 / $1,015.99 / $1,450.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $644.74 / $1,063.63
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
$928.07 / $1,095.44 / $1,512.64