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Michigan rates for HCPCS 21453

Closed treatment of mandibular fracture with interdental fixation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $4,897.79 / $7,943.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,041.74 / $2,041.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $4,073.80 / $7,585.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $7,413.10 / $12,882.50