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Michigan rates for HCPCS D4261

Osseous Surg 1-3 Contig/Tooth Bound Spaces-Quad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.54 / $247.54 / $247.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.94 / $247.54 / $256.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.10 / $287.10 / $312.51
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.54 / $247.54 / $247.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.63 / $247.54 / $247.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00