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Michigan rates for HCPCS 25265

Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$961.79 / $4,112.00 / $6,906.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.96 / $839.32 / $998.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,322.81 / $3,900.01 / $5,283.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.07 / $951.49 / $1,989.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.22 / $929.07 / $1,605.11
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$780.75 / $4,112.00 / $5,756.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.96 / $858.82 / $1,245.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $532.50 / $887.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,500.00 / $7,780.00 / $9,202.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.70 / $934.13 / $1,225.44