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Michigan rates for HCPCS 28490

Cltx Fx Grt Toe Phlx/Phlg W/O Manj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.62 / $233.94 / $4,933.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$118.75 / $123.32 / $139.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.84 / $153.63 / $244.65
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.77 / $143.40 / $146.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.72 / $182.77 / $247.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.27 / $205.48 / $326.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.45 / $152.40 / $267.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.81 / $233.94 / $4,933.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$118.75 / $118.75 / $134.09
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.88 / $164.41 / $245.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.69 / $100.71 / $161.48
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
$137.40 / $165.33 / $252.60