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Michigan rates for HCPCS A9604

Sm 153 Lexidronam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,631.57 / $15,631.57 / $15,631.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,631.57 / $15,631.57 / $16,608.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,611.56 / $24,254.98 / $43,131.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,468.74 / $16,282.88 / $19,539.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,520.26 / $16,608.54 / $16,608.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,631.57 / $17,576.37 / $19,539.46
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,631.57 / $17,259.84 / $20,711.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $16,282.88 / $19,539.46