go back

Michigan rates for HCPCS 40761

Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,377.17 / $4,112.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.17 / $1,377.17 / $1,377.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,802.84 / $5,597.88 / $7,584.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.49 / $439.13 / $1,707.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$985.00 / $1,229.69 / $4,217.16
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.82 / $4,112.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.82 / $1,218.34 / $1,713.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.25 / $845.44 / $1,272.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,069.00 / $8,702.00 / $12,726.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.84 / $1,362.46 / $1,769.65