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Forearm Bone Cyst Removal With Donor Graft

New Hampshire 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 $3,890 · 10th–90th $2,089$11,4820%10%20%10th90th$3,890Professionalmedian $933 · 10th–90th $617$1,4790%10%10th90th$933$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$100.00
Median
$2,398.83
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$616.60
Typical High
$758.58
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,677.35
Typical High
$6,309.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$1,174.90
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$977.24
Typical High
$1,862.09
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$954.99
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,047.13
Typical High
$1,819.70
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$251.19
Typical High
$724.44