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New York 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
$887.07 / $4,640.82 / $10,526.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,248.00 / $5,196.00 / $11,909.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.98 / $2,390.00 / $10,957.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$771.12 / $771.12 / $771.12
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $947.00 / $1,809.36
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$639.33 / $639.33 / $639.33
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,394.91 / $2,394.91 / $2,394.91
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $771.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,248.00 / $11,200.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$813.46 / $813.46 / $2,901.86