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New York 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
$954.99 / $4,265.80 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $812.83 / $1,949.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $5,888.44 / $12,302.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $724.44 / $1,621.81
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,995.26 / $8,912.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,096.48 / $3,090.30
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $794.33 / $1,862.09
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,096.48 / $1,584.89
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $691.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $977.24 / $1,548.82
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $954.99 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $5,888.44 / $13,489.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $891.25 / $2,187.76
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $891.25 / $3,715.35
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $891.25 / $2,238.72