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Michigan rates for HCPCS 54111

Exc Penile Plaque Graft &/5 Cm Length

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,014.49 / $2,877.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.83 / $1,014.49 / $1,027.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,071.96 / $4,753.21 / $6,475.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.26 / $747.28 / $1,278.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.76 / $929.06 / $1,633.52
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$811.35 / $2,877.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.35 / $902.54 / $1,310.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.66 / $688.40 / $1,040.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,069.00 / $8,847.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$883.76 / $1,078.93 / $1,344.55