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Wisconsin rates for HCPCS 25275

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

Facilitymedian $8,128 · 10th–90th $1,778–$12,3030%10%10th90th$8,128Professionalmedian $1,479 · 10th–90th $977–$2,1880%10%20%10th90th$1,479$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,511.89 / $12,302.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,317.64 / $13,182.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,041.74 / $3,311.31
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,380.38 / $6,760.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,412.54 / $11,481.54
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $8,511.38 / $9,120.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,479.11 / $2,187.76
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $6,025.60 / $8,912.51
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $10,000.00 / $12,022.64