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Michigan rates for HCPCS 70552

Mri Brain Brain Stem W/Contrast Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$109.24 / $109.24 / $137.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.12 / $449.30 / $603.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$86.09 / $139.52 / $199.08
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$125.00 / $173.76 / $237.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$193.96 / $314.52 / $462.42
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.12 / $163.12 / $163.12
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.91 / $78.64 / $107.81
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$132.58 / $132.58 / $132.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.99 / $317.39 / $451.36
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$133.68 / $133.68 / $133.68
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$305.18 / $305.18 / $305.18
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$96.46 / $96.46 / $96.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.20 / $536.24 / $979.74
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.96 / $103.04 / $208.68
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$213.06 / $376.60 / $699.97
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$69.95 / $109.24 / $137.63
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.02 / $423.71 / $603.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$69.95 / $109.24 / $176.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$149.52 / $173.76 / $375.29
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$208.82 / $335.00 / $477.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.51 / $196.97 / $304.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.30 / $399.03 / $689.96
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$79.31 / $93.34 / $147.75
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$203.18 / $270.77 / $564.79