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Nebraska rates for HCPCS 25115

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,752.78 / $10,431.19 / $20,928.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,094.34 / $5,385.17 / $10,416.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,257.44 / $1,257.44 / $1,257.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.80 / $1,217.65 / $4,217.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,257.44 / $1,597.29 / $2,253.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $6,451.00 / $7,934.00