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Michigan rates for HCPCS 43460

Esophagogastric tamponade, with balloon (Sengstaken type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.08 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.28 / $240.98 / $282.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.54 / $200.54 / $200.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.42 / $1,173.07 / $1,572.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.33 / $218.10 / $348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.05 / $265.72 / $538.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.21 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.35 / $234.28 / $338.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.30 / $204.49 / $294.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.00 / $4,645.00 / $6,036.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.23 / $282.77 / $365.21