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Michigan rates for HCPCS 21142

Rcnstj Midface Lefort I 2 Pieces W/O Bone Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,732.48 / $4,933.00 / $6,906.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,171.19 / $1,399.83 / $1,799.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,626.51 / $7,777.57 / $10,537.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.03 / $1,381.86 / $2,354.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.10 / $1,532.75 / $2,992.27
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,471.04 / $1,799.11 / $6,906.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.57 / $1,525.12 / $2,331.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.88 / $929.76 / $1,564.23
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
$1,373.27 / $1,666.14 / $2,359.76