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Michigan rates for HCPCS 43622

Gstrct Tot W/Frmj Intstinal Pouch Any Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,990.65 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.60 / $2,673.84 / $2,990.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,431.04 / $12,465.32 / $17,209.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.42 / $2,267.66 / $3,695.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,006.69 / $2,805.00 / $5,423.24
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,409.41 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,324.77 / $2,546.17 / $3,671.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.26 / $1,968.71 / $2,972.55
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
$2,382.30 / $3,055.58 / $3,904.79