go back

Maryland 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
$3,230.18 / $3,230.18 / $3,230.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.59 / $735.93 / $1,342.18
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$746.35 / $746.35 / $845.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.00 / $518.54 / $1,490.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.59 / $922.25 / $1,671.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.75 / $1,005.88 / $1,315.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.18 / $847.00 / $6,489.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.41 / $830.70 / $1,544.22
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.01 / $896.71 / $1,101.18