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Forearm Bone Cyst Removal With Donor Graft

Pennsylvania 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 $4,786 · 10th–90th $1,047$8,3180%10%10th90th$4,786Professionalmedian $631 · 10th–90th $537$1,2300%20%40%10th90th$631$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$1,023.29
Median
$4,786.30
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$616.60
Typical High
$1,230.27
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$7,585.78
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$645.65
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$758.58
Typical High
$1,288.25
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$933.25
Typical High
$1,174.90
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$831.76
Typical High
$1,905.46
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$676.08
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$3,981.07
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$676.08
Typical High
$2,570.40
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$933.25
Typical High
$977.24
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,949.84
Typical High
$3,388.44
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$588.84
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$4,365.16
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$724.44
Typical High
$1,174.90