go back

Michigan rates for HCPCS 30920

Ligation arteries; internal maxillary artery, transantral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,000.00 / $1,659.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $977.24 / $1,380.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $4,073.80 / $5,754.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,000.00 / $1,348.96
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $977.24 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $5,754.40 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $977.24 / $1,412.54