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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
$3,235.94 / $3,235.94 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $741.31 / $1,949.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $812.83 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $891.25 / $1,659.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $812.83 / $1,318.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $851.14 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $831.76 / $1,479.11
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $870.96 / $1,122.02