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Michigan rates for HCPCS L1300

Other scoliosis procedure, body jacket molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.89 / $1,185.89 / $1,185.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$999.37 / $1,185.89 / $1,185.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,142.98 / $6,262.01 / $11,405.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,972.71 / $2,076.54 / $2,803.33
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.23 / $1,348.82 / $1,349.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,661.23 / $1,661.23 / $1,661.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.46 / $1,277.46 / $1,277.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,277.46 / $1,277.46 / $2,407.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.89 / $1,500.62 / $1,500.62
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,130.26 / $1,500.62 / $2,180.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,260.04 / $1,536.64 / $1,767.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.11 / $975.16 / $1,489.02