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Michigan rates for HCPCS 21155

Rcnstj Midface Lefort Iii W/Lefort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,766.20 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,948.01 / $2,724.50 / $2,872.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.04 / $11,516.46 / $15,602.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.90 / $2,240.54 / $3,584.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,616.82 / $2,613.92 / $4,630.18
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,156.61 / $2,766.20 / $6,906.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,130.85 / $2,415.40 / $3,587.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.09 / $1,447.40 / $2,423.91
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
$2,156.61 / $2,711.16 / $3,494.30