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Michigan rates for HCPCS 25250

Removal of wrist prosthesis; (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$685.23 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$483.00 / $685.23 / $711.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,202.02 / $2,584.52 / $3,501.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.85 / $822.67 / $1,357.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.08 / $594.66 / $1,142.39
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$539.21 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$538.23 / $593.13 / $881.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $382.23 / $619.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $3,640.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.03 / $631.29 / $865.54