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Michigan rates for HCPCS 35876

Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $6,918.31 / $9,120.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $234.42 / $2,041.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $4,897.79 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $9,120.11 / $14,791.08