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Michigan rates for HCPCS 57311

Closure of urethrovaginal fistula; with bulbocavernosus transplant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.09 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.34 / $652.09 / $679.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,455.07 / $2,865.80 / $3,904.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.72 / $580.90 / $960.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.14 / $588.54 / $1,144.42
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$526.85 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.85 / $603.42 / $843.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.66 / $471.42 / $715.05
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
$570.78 / $701.44 / $882.54