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Michigan rates for HCPCS 27057

Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,293.86 / $2,877.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$909.96 / $1,285.82 / $1,343.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,464.17 / $1,718.50 / $2,328.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.00 / $1,602.63 / $2,546.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$738.35 / $1,142.33 / $2,143.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.71 / $2,877.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.71 / $1,070.31 / $1,577.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.66 / $683.30 / $1,160.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $5,806.00 / $8,339.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$969.55 / $1,173.20 / $1,590.85