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Utah rates for HCPCS 25263

Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $891.25 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $870.96 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,096.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,471.29 / $12,302.69 / $28,183.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,202.26 / $1,584.89
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $1,174.90 / $1,513.56
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $954.99 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $676.08 / $1,071.52