go back

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
$439.80 / $4,112.00 / $12,387.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,061.67 / $2,447.98 / $3,362.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.84 / $4,112.00 / $6,906.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $5,819.00 / $7,355.00