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Nebraska 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
$4,265.80 / $7,585.78 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $741.31 / $4,073.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $5,370.32 / $10,471.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,122.02 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,621.81 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,174.90 / $8,709.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,348.96 / $5,623.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,659.59 / $2,290.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,659.59 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $6,456.54 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,288.25 / $1,778.28