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Michigan rates for HCPCS 96522

Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.46 / $132.13 / $154.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.38 / $108.38 / $108.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.66 / $175.16 / $208.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.59 / $143.55 / $322.06
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.96 / $119.59 / $165.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.57 / $100.87 / $147.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.83 / $124.51 / $157.32