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Forearm Bone Cyst Removal With Donor Graft

Hawaii rates for HCPCS 25126

A surgery to scrape out or remove a fluid-filled cyst or noncancerous growth from one of the forearm bones, followed by filling the resulting space with donor bone graft material from a bone bank rather than bone taken from the patient's own body. It treats a benign bone lesion while supporting the bone's structure and healing where the growth was removed. It is a more involved version of forearm bone cyst removal than one performed without any graft material.

Rates data updated July 2026.

Facilitymedian $4,467 · 10th–90th $1,318$4,4670%50%10th$4,467Professionalmedian $2,512 · 10th–90th $589$6,1660%10%10th90th$2,512$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$4,466.84
Typical High
$4,466.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$588.84
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$776.25
Typical High
$933.25
HMSA
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$977.24
Typical High
$1,174.90
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$707.95
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$2,238.72
Typical High
$2,238.72
United
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$851.14
Typical High
$933.25
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$3,235.94
Typical High
$6,165.95