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Michigan rates for HCPCS 50520

Closure of nephrocutaneous or pyelocutaneous fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,500.68 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.83 / $1,500.68 / $1,500.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,843.39 / $5,653.70 / $7,701.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.38 / $1,746.92 / $3,406.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,048.55 / $1,278.18 / $2,331.27
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.54 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.54 / $1,242.85 / $1,707.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $1,004.68 / $1,514.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$325.13 / $2,246.00 / $4,504.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,215.00 / $1,450.14 / $1,921.34