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Idaho rates for HCPCS 25274

Repair, tendon or muscle, extensor, 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
$3,422.00 / $4,500.00 / $8,622.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$675.78 / $979.05 / $1,359.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,895.78 / $1,895.78 / $1,901.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.14 / $1,021.12 / $1,259.52
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$647.87 / $1,359.42 / $1,644.90
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.19 / $1,194.75 / $1,566.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $938.65 / $1,180.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,834.98 / $7,849.65 / $9,927.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.34 / $1,351.00 / $1,566.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,500.00 / $9,360.00 / $17,870.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.22 / $1,049.88 / $1,420.06