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Missouri 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
$1,547.00 / $5,389.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.89 / $677.62 / $1,382.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.64 / $1,061.64 / $1,061.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $4,279.00 / $8,563.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.75 / $883.00 / $1,299.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.56 / $930.83 / $1,451.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$619.59 / $1,079.82 / $8,957.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.75 / $995.66 / $5,932.82
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.89 / $1,220.89 / $1,220.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.00 / $3,502.00 / $6,854.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$625.78 / $885.17 / $1,430.49