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Michigan rates for HCPCS E1353

Regulator (Special Coverage Instructions Apply. See Cim: 60-4 And Mcm: 4107.9)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.75 / $30.13 / $30.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.94 / $25.06 / $30.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.17 / $110.68 / $214.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $37.59 / $47.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.72 / $25.72 / $25.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.66 / $31.66 / $31.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.17 / $25.17 / $29.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.39 / $25.17 / $48.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $28.60 / $30.13
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.86 / $28.60 / $1,186.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.14 / $18.39 / $32.86