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Louisiana 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
$739.00 / $2,397.00 / $4,050.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.49 / $857.00 / $1,158.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,712.54 / $5,175.18 / $7,440.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.32 / $867.69 / $1,213.66
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $599.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.00 / $1,350.00 / $1,350.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.10 / $936.80 / $1,274.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $3,238.00 / $9,160.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.71 / $796.44 / $1,377.53