go back

Michigan rates for HCPCS 21267

Orbital Repositioning W/Bone Grafts Extracranial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,032.99 / $4,933.00 / $6,853.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,440.93 / $2,032.99 / $2,111.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,110.10 / $5,997.76 / $8,126.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.89 / $1,606.85 / $2,672.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,165.13 / $1,817.57 / $3,475.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,611.51 / $4,933.00 / $6,853.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,593.20 / $1,796.01 / $2,636.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.33 / $1,075.81 / $1,832.42
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
$1,575.80 / $1,885.81 / $2,590.75