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Michigan rates for HCPCS 53454

Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.95 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.68 / $43.95 / $43.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.65 / $142.13 / $142.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.65 / $149.24 / $252.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.42 / $65.61 / $80.90
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,056.00 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.82 / $43.95 / $189.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.00 / $1,428.00 / $2,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.41 / $30.37 / $73.26