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Michigan rates for HCPCS 61640

Balloon Dilat Intracranial Vasospasm Prq Initial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.85 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.18 / $566.77 / $646.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.60 / $118.60 / $139.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.34 / $485.01 / $732.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.71 / $772.50 / $1,413.04
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$617.98 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.41 / $617.98 / $759.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $425.39 / $830.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,713.00 / $3,869.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.35 / $730.47 / $932.72