go back

Michigan 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
$854.15 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.73 / $854.15 / $887.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.64 / $1,061.64 / $1,061.64
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
$180.66 / $1,021.86 / $1,704.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.94 / $828.11 / $1,426.02
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.36 / $854.15 / $6,906.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.93 / $764.49 / $1,113.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.56 / $460.38 / $784.12
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
$674.74 / $843.09 / $1,109.79