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Michigan rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $954.99 / $1,698.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $1,380.38 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,096.48 / $2,041.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $2,818.38 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,071.52 / $1,479.11
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $912.01 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $3,890.45 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,071.52 / $1,412.54