go back

Michigan rates for HCPCS C9354

Acellular pericardial tissue matrix of nonhuman origin (Veritas), per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.23 / $18.23 / $18.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.23 / $18.23 / $19.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.38 / $19.38 / $19.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.23 / $20.14 / $22.80
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.23 / $20.14 / $24.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $100.00