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Michigan rates for HCPCS 28805

Amputation, foot; transmetatarsal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,584.89 / $1,584.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $4,073.80 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $4,786.30 / $8,709.64