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Michigan rates for HCPCS D0250

extra-oral - 2D projection radiographic image created using a stationary radiation source, and detector

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.74 / $20.74 / $20.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.01 / $20.74 / $21.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $21.41 / $21.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.74 / $20.74 / $20.74
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.01 / $20.74 / $22.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00