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Michigan rates for HCPCS A6454

Self-adherent bandage, elastic, nonknitted/nonwoven, width greater than or equal to 3 in and less than 5 in, per yd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $0.83 / $0.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.83 / $0.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $3.32 / $6.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.13 / $1.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.55 / $1.41
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.78 / $0.78 / $0.89
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $0.78 / $1.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.54 / $0.62 / $0.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.51 / $0.79