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Michigan rates for HCPCS 27197

Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.51 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $133.85 / $177.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.92 / $183.92 / $183.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.67 / $399.85 / $541.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.11 / $182.44 / $230.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.73 / $142.94 / $282.61
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.29 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.29 / $133.72 / $190.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.37 / $136.03 / $193.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $1,418.00 / $2,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.62 / $151.79 / $195.85