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Michigan rates for HCPCS 21387

Open Tx Orbital Floor Blowout Fx Combined Appr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.24 / $4,933.00 / $5,757.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$688.31 / $974.24 / $1,011.71
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
$196.49 / $1,213.59 / $1,855.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.83 / $843.94 / $1,660.90
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.87 / $4,933.00 / $5,757.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.75 / $849.65 / $1,220.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $522.40 / $868.22
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
$766.28 / $894.41 / $1,203.19