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Georgia rates for HCPCS 25275

Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,064.45 / $4,829.00 / $6,915.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,082.02 / $3,088.55 / $6,315.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,178.04 / $1,425.05 / $1,938.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$771.12 / $771.12 / $2,172.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.17 / $1,134.67 / $1,777.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,519.00 / $6,351.00 / $8,836.00