go back

Virginia rates for HCPCS 21725

Division Sternocleidomastoid Open W/Cast

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$608.44 / $5,087.00 / $8,294.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.30 / $572.21 / $722.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,735.00 / $2,390.00 / $2,954.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.31 / $650.02 / $1,074.67
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.38 / $595.00 / $983.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.84 / $620.84 / $640.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.40 / $675.95 / $1,184.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.52 / $672.08 / $794.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$541.38 / $713.88 / $1,028.43
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.00 / $761.00 / $1,016.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$495.32 / $666.62 / $1,346.50
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.32 / $666.62 / $1,346.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$921.00 / $1,890.00 / $3,765.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.80 / $658.71 / $1,046.49