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Michigan rates for HCPCS G0121

Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For High Risk (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.93 / $1,685.38 / $3,007.50
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$91.73 / $168.47 / $1,438.50
Aetna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$66.73 / $112.57 / $176.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.87 / $290.45 / $556.34
Aetna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$37.04 / $91.92 / $172.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.89 / $243.50 / $314.80
Ambetter
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$90.53 / $166.69 / $175.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.48 / $1,344.00 / $3,222.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.34 / $184.54 / $304.10
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.28 / $138.32 / $256.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.29 / $227.99 / $463.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.18 / $301.75 / $498.82
Cigna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$75.09 / $174.72 / $365.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.61 / $1,734.94 / $3,078.53
Health Alliance Plan
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$91.73 / $1,370.00 / $1,438.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$91.92 / $140.97 / $200.45
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.46 / $336.93 / $572.66
Health Alliance Plan
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$55.06 / $140.97 / $208.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.31 / $244.97 / $379.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.00 / $3,005.00 / $4,504.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.68 / $485.53 / $679.06
United
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$204.84 / $204.84 / $204.84