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Michigan rates for HCPCS C9604

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $6,456.54 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,218.10 / $16,218.10 / $16,218.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $11,220.18 / $11,220.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $11,220.18 / $11,220.18
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $6,918.31 / $9,549.93
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,079.46 / $7,762.47 / $16,218.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $11,481.54 / $28,840.32