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Michigan rates for HCPCS L2500

Addition to lower extremity, thigh/weight bearing, gluteal/ischial weight bearing, ring

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $199.53 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $1,148.15 / $2,187.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $380.19 / $398.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $245.47 / $446.68
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $724.44 / $794.33
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $302.00 / $457.09
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $245.47 / $251.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $302.00 / $478.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $177.83 / $269.15