go back

Michigan rates for HCPCS 21172

Rcnstj Superior-Lateral Orbital Rim & Lower Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,741.50 / $4,933.00 / $5,757.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,652.75 / $2,335.87 / $3,152.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,968.13 / $5,831.13 / $7,900.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.35 / $2,082.92 / $3,685.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,603.49 / $2,228.88 / $4,243.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,840.85 / $4,933.00 / $5,757.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.85 / $2,157.55 / $3,524.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.69 / $1,404.83 / $2,464.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,500.00 / $7,800.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,918.63 / $2,291.98 / $3,220.81