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Michigan rates for HCPCS 80337

Antidepressants Tricyclic Other Cyclicals 6/More

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $84.00 / $141.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.81 / $9.81 / $9.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.67 / $9.81 / $13.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.67 / $29.30 / $34.59
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $9.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.40 / $9.40 / $11.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00