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Michigan rates for HCPCS 21210

Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$958.96 / $4,933.00 / $6,853.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.91 / $1,569.66 / $2,359.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,664.16 / $4,300.64 / $5,826.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.15 / $1,153.82 / $1,990.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.03 / $1,332.11 / $2,966.63
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,182.21 / $4,933.00 / $6,853.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.85 / $2,191.88 / $2,961.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.56 / $1,163.66 / $1,975.59
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
$1,767.64 / $2,355.17 / $3,503.88