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Michigan rates for HCPCS B4083

Stomach Tube - Levine Type (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.14 / $2.14 / $3.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.43 / $2.14 / $2.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.59 / $5.48 / $10.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.02 / $2.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.06 / $1.18 / $2.10
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.14 / $2.29 / $2.29
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.57 / $2.14 / $2.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.25 / $3.42