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Michigan rates for HCPCS 95875

Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.60 / $137.72 / $155.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.94 / $126.39 / $215.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.79 / $191.75 / $520.82
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.84 / $130.53 / $168.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.01 / $77.78 / $119.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.18 / $128.10 / $212.75