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Indiana rates for HCPCS 25455

Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$681.65 / $2,318.00 / $11,093.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.16 / $684.11 / $938.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,318.00 / $6,474.00 / $13,758.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.98 / $958.20 / $1,322.31
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.68 / $932.89 / $1,399.34
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.35 / $832.94 / $1,199.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,116.34 / $2,116.34 / $2,508.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.28 / $974.77 / $1,503.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,370.00 / $10,069.00 / $15,750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.67 / $794.63 / $1,389.61