go back

Michigan 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
$4,073.80 / $4,073.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $741.31 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $1,202.26 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $851.14 / $1,862.09
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $4,073.80 / $5,754.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $812.83 / $1,122.02
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $758.58 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $6,309.57 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $812.83 / $1,047.13