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Michigan rates for HCPCS 27137

Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,876.67 / $4,933.00 / $5,757.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$938.34 / $938.34 / $974.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,916.11 / $8,117.48 / $10,997.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,536.29 / $4,933.00 / $5,757.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$938.34 / $938.34 / $938.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,356.00 / $11,464.00 / $17,095.00