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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
$4,933.00 / $6,527.00 / $6,906.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,535.00 / $15,390.00 / $19,995.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,027.12 / $14,158.34 / $33,406.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,575.01 / $10,773.54 / $11,907.60
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,933.00 / $6,527.00 / $6,906.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,853.00 / $7,019.76 / $10,205.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,850.00 / $12,544.00 / $29,001.00