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Forearm Bone Cyst Removal With Donor Graft

South Dakota 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 $1,318 · 10th–90th $724$4,3650%10%10th90th$1,318Professionalmedian $1,047 · 10th–90th $513$1,7380%10%10th90th$1,047$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$3,548.13
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$602.56
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,412.54
Typical High
$1,778.28
Medica
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,023.29
Typical High
$1,548.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$1,047.13
Typical High
$5,248.07
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,348.96
Typical High
$1,348.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,288.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,023.29
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,000.00
Typical High
$1,659.59
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,258.93
Typical High
$1,479.11