go back

Maine 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
Professional
Modifier
Low / Median / High Price
$557.51 / $704.41 / $841.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.55 / $904.01 / $1,295.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.14 / $1,038.98 / $1,444.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$845.83 / $978.63 / $1,501.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.51 / $809.80 / $841.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.70 / $920.56 / $1,345.81