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Michigan rates for HCPCS G0415

Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.37 / $4,933.00 / $5,757.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,418.26 / $7,533.15 / $10,206.21
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.37 / $4,933.00 / $5,757.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,635.00 / $10,192.00 / $12,767.00