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Michigan rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,181.44 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.03 / $2,098.46 / $2,265.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,878.70 / $8,073.58 / $10,938.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.55 / $1,764.26 / $3,121.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,268.47 / $1,866.32 / $3,584.92
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,785.64 / $2,181.44 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,718.25 / $1,963.71 / $2,730.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.36 / $1,242.75 / $2,047.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.00 / $4,645.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,655.04 / $1,921.97 / $2,856.22