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Michigan rates for HCPCS 69604

Revj Mastoidectomy Rsltg Tympanoplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,310.04 / $4,933.00 / $6,853.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$973.63 / $1,310.04 / $1,419.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,802.84 / $5,597.88 / $7,584.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.27 / $1,658.77 / $2,612.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.12 / $1,276.19 / $2,297.03
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,145.70 / $4,933.00 / $6,853.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,145.70 / $1,234.09 / $1,683.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.66 / $838.69 / $1,323.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,069.00 / $7,935.00 / $10,652.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,142.07 / $1,367.22 / $1,849.32