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Michigan rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $4,073.80 / $12,302.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $776.25 / $776.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $1,412.54 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $4,897.79 / $12,022.64