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Michigan rates for HCPCS 42200

Palatoplasty for cleft palate, soft and/or hard palate only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $5,754.40 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,023.29 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $281.84 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,380.38 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,202.26 / $2,511.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $4,897.79 / $15,848.93
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,023.29 / $1,737.80
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,047.13 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $7,079.46 / $12,882.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,096.48 / $1,584.89