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Michigan rates for HCPCS A4708

Acetate Conc Sol Per Gallon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.80 / $28.96 / $59.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.26 / $11.34 / $13.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.60 / $39.60 / $39.60
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $6.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $75.00