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Michigan rates for HCPCS L5925

Addition Endoskeletal System Above Knee Knee Disarticulation Or Hip Disarticulation Manual Lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.32 / $230.32 / $230.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.01 / $230.32 / $230.32
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.47 / $302.47 / $302.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$610.41 / $1,216.16 / $2,215.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.13 / $403.29 / $544.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.14 / $262.14 / $349.52
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.63 / $322.63 / $322.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.88 / $260.88 / $260.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.88 / $260.88 / $467.63
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.32 / $291.44 / $291.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.19 / $291.44 / $453.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.66 / $298.43 / $343.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.67 / $201.20 / $310.04