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Michigan rates for HCPCS 50400

Pyeloplasty Simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,464.62 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.06 / $1,350.03 / $1,757.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,446.99 / $6,358.28 / $8,661.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.57 / $1,721.03 / $2,710.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,067.68 / $1,337.72 / $2,359.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,173.51 / $2,619.10 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,173.51 / $1,300.95 / $2,163.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.78 / $1,005.70 / $1,494.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $7,849.00 / $9,202.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,313.53 / $1,563.09 / $2,121.96