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Michigan rates for HCPCS A4257

Replacement Lens Shield Cartridge For Use With Laser Skin Piercing Device Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.02 / $13.58 / $14.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.82 / $17.82 / $17.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.94 / $18.54 / $24.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $26.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $14.81
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.75 / $12.88 / $21.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.16 / $75.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.30 / $8.36 / $12.75