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Michigan rates for HCPCS 80177

Levetiracetam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.58 / $13.75 / $43.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $9.65 / $13.25
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.21 / $9.21 / $9.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.83 / $14.99 / $26.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $9.94 / $13.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.94 / $13.25 / $36.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.61 / $8.61 / $13.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $15.28 / $19.10
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.33 / $15.74 / $51.21
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.64 / $15.23 / $17.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.88 / $10.98 / $14.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.57 / $10.85 / $11.51