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Michigan rates for HCPCS 21179

Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $2,691.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $2,290.87 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $2,290.87 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,819.70 / $4,365.16
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $4,897.79 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,698.24 / $2,290.87
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,584.89 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,943.28 / $14,791.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,737.80 / $2,238.72